Molecular Epidemiology and Antimicrobial Susceptibility of Clostridium difficile Isolates from a University Teaching Hospital in China
Molecular Epidemiology and Antimicrobial Susceptibility of Clostridium difficile Isolates from a University Teaching Hospital in China
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DOI：
10.3389/fmicb.2010.01021
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发表时间：
2016-10-17
影响因子：
5.2
通讯作者：
Xu, Ying-Chun
中科院分区：
文献类型：
--
作者：
Cheng, Jing-Wei;Xiao, Meng;Xu, Ying-Chun
虽然发达国家关于艰难梭菌感染（CDI）的科学文章数量显着增加，但由于实验室能力有限，认识不足以及对该问题的监测有限，发展中国家在这一问题上仍然落后。因此，在发展中国家，CDI被认为是一个被忽视但潜在的巨大问题。本研究的主要目的是系统地评估几种分子分型工具对CDI的实用性，包括它们在发展中国家（如中国）流行病学研究中的相关性。共检测到116株非重复重复序列的C.分离自中国患者的艰难梭菌。其中A+B+CDT-83株（71.6%），A B+CDT-27株（23.3%），A+B+CDT+6株（5.1%）。评估的分型方法包括多位点可变数目串联重复序列分析，PCR核糖体分型，多位点序列分型，和测序的slicA和tcdC基因，确定113，30，22，18，和8个基因型，分别表现出0.999，0.916，0.907，0.883，和0.765，分别。与A+B+菌株相比，A-B+菌株对克林霉素、红霉素、左氧氟沙星、利福平、利福昔明和四环素的耐药率较高。此外，具有不同PCR核糖体型的菌株的耐药率不同，支持分子分型在管理和控制CDI中的重要性。根据我们先前提出的提高发展中国家CDI诊断实验室能力的建议，建立有效的监测计划并辅以相关的分子分型方法是必要的。
While the developed world has seen a significant increase in the number of scientific articles on Clostridium difficile infection (CDI), the developing world still lags behind on this subject due to limited laboratory capacity, low awareness, and limited surveillance of this problem. As such, CDI is considered a neglected but potentially huge problem in developing countries. The major aim of this study was to systemically evaluate the utility of several molecular typing tools for CDI, including their relevance in epidemiological studies in developing countries such as China. A total of 116 non repetitive toxigenic C. difficile isolates from Chinese patients, were studied. The isolates comprised 83 (71.6%) A+B+CDT- isolates, 27 (23.3%) A B+CDT- isolates, and 6 (5.1%) A+B+CDT+ isolates. Typing methods evaluated included multilocus variable number tandem-repeat analysis, PCR ribotyping, multilocus sequence typing, and sequencing of slicA and tcdC genes, which identified 113, 30, 22, 18, and 8 genotypes each and exhibited discriminatory powers of 0.999, 0.916, 0.907, 0.883, and 0.765, respectively. Compared to A+B+ strains, A-B+ strains exhibited higher prevalence of drug resistance to clindamycin, erythromycin, levofloxacin, rifampicin, rifaximin, and tetracycline. Furthermore, drug resistance rates of strains with different PCR ribotypes differed, supporting the importance of molecular typing in management and control of CDI. Based on our earlier suggestion to improve the diagnostic laboratory capacity of CDI in developing countries, setting up efficient surveillance programs complemented by relevant molecular typing methods is warranted.