Clostridium difficile carriage in healthy pregnant women in China

Ye, Guang-yong; Li, Na; Chen, Yunbo; Lv, Tao; Shen, Ping; Gu, Silan; Fang, Yanran

doi:10.1016/j.anaerobe.2015.11.010

Cited by 10 publications

(5 citation statements)

References 18 publications

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“…Although the dominant C. difficile toxigenic type is A+B+, there has been an increase in the prevalence and significance of the A-B+ type in some regions of the world ( Kim et al, 2008 ; King et al, 2015 ). In this study, 23.3% of the isolates were A-B+CDT-, which is in agreement with previous studies in China in which the average prevalence rate of A-B+ strains is 21.4% (201/937), ranging from 0 to 53.6% by geographic distribution ( Huang et al, 2009 , 2010 ; Dong et al, 2013 ; Hawkey et al, 2013 ; Yan et al, 2013 ; Chen et al, 2014 ; Fang et al, 2014 ; Wang et al, 2014 ; Zhou et al, 2014 ; Cheng et al, 2015 ; Ye et al, 2015 ; Tian et al, 2016 ). Interestingly, infection with CDT-positive C. difficile strains has been reported to be associated with higher mortality and recurrence rates ( Stewart et al, 2013 ).…”

Section: Discussionsupporting

confidence: 92%

“…The predominant ribotype and ST identified in the present study was ribotype 012/ST54 (16.4%), followed by ribotypes 001/ST3 (14.7%) and 017/ST37 (13.8%), whilst the commonest ribotype is ribotype 012 reported overall in China (100 of 589 isolates, 17.0%), and ST54, ST3, ST35, and ST37 (prevalence of 21.4, 12.6, 11.0, and 9.4 of 682 isolates tested, respectively) rank the top four STs ( Huang et al, 2009 , 2010 ; Dong et al, 2013 ; Hawkey et al, 2013 ; Yan et al, 2013 ; Chen et al, 2014 ; Fang et al, 2014 ; Wang et al, 2014 ; Zhou et al, 2014 ; Cheng et al, 2015 ; Ye et al, 2015 ; Tian et al, 2016 ). The remaining ribotypes/STs were distributed sporadically among different departments and with a lower prevalence.…”

Section: Discussionmentioning

confidence: 99%

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Molecular Epidemiology and Antimicrobial Susceptibility of Clostridium difficile Isolates from a University Teaching Hospital in China

et al. 2016

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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 slpA 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.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Molecular Epidemiology and Antimicrobial Susceptibility of Clostridium difficile Isolates from a University Teaching Hospital in China

et al. 2016

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“…All of the clinical isolates were typed into 26 MLST genotypes. ST-54, ST-2, and ST-37 were the most common types in the study hospital, which is consistent with previous reports from China (Ye et al, 2016). C. difficile strain BI/NAP1/027, belonging to ST-1, which is responsible for high rates of recurrence and mortality, has become a significant concern globally over recent years (Goorhuis et al, 2007;Cheng et al, 2016).…”

Section: Discussionsupporting

confidence: 90%

Molecular epidemiology and antimicrobial susceptibility of Clostridium difficile isolated from the Chinese People’s Liberation Army General Hospital in China

Wang

Suo

Chen

et al. 2018

International Journal of Infectious Diseases

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Clostridium difficile is a Gram-positive, spore-forming obligate anaerobe responsible for antibiotic-associated diarrhoea. Its virulence is associated with the production of endotoxins A and B and endospores, which can cause symptoms, such as diarrhoea, toxic megacolon, and pseudomembranous colitis. Given the increasing elderly population and the well-recognized problem of over-prescribing of broad-spectrum antibiotics, it is critical to have an understanding of molecular epidemiology and antimicrobial susceptibility in China. This study analyzed the toxin types and multilocus sequence typing (MLST) results of 74 clinical isolates of C. difficile after the glutamate dehydrogenase (GDH) screening test and anaerobic culture. The minimum inhibitory concentrations (MICs) of four different antibiotics were determined for all of the isolates, and the bacterial resistance mechanisms were investigated. Sixty-five strains (75%) were toxigenic, including 54 tcdA-positive, tcdB-positive, and cdtA/cdtB-negative strains (ABCDT) and nine ABCDT strains. Eleven strains (14.9%) were non-toxigenic. All clinical isolates were classified into 26 MLST genotypes, with the predominant type being ST-54 (18.9%). All isolates were susceptible to vancomycin. The tetracycline, clindamycin, and levofloxacin resistance rates were 1.4%, 36.5%, and 20.3%, respectively. The expression of tet(M), erm(B), and mutations of gyrA and/or gyrB were observed in the tetracycline-, clindamycin-, and levofloxacin-resistant isolates, respectively.

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“…Meanwhile, many literatures reported that ST54 was widely distributed in the world and was detected in Japan, India, Chile and other places [29]. It has also been reported that ST54 occupies the second place of CDI in domestic pregnant women [30].…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Clostridioides difficile infection in inflammatory bowel disease

Tang

Liu

Yan

et al. 2020

Preprint

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Background: The epidemiology of Clostridioides difficile infection(CDI) in China is different from western countries and the characteristics of CDI among inflammatory bowel disease (IBD) in China may be unique. The aim of this study was to investigate the molecular epidemiology and to find out the risk factors of CDI among IBD inpatients in Jiangsu Province, China. Methods: Patients with IBD admitted to the First Affiliated Hospital with Nanjing Medical University from August 2013 to December 2018 were enrolled. IBD patients were matched with non IBD patients according to age and gender. Diarrhea samples were sent for CDI diagnosis and the molecular epidemiology investigation was performed. Finally, patients’ information was collected and logistic regression analysis was performed to analyze the independent risk factors of CDI in IBD patients. Results: In this study, the incidence of CDI in IBD patients was much higher than that in non IBD patients (24.6% vs. 9.0%) and community acquired infection was the main kind. The predominant type of epidemic strain of C. difficile in this study was ST54. The shorter history of IBD and recent use of quinolone antibiotics were independent risk factors for CDI among diarrhea patients with IBD. Conclusion: If the duration of IBD is within one year or quinolone antibiotics have been used recently, clinicians should consider the possibility of IBD patients complicated with CDI and adjust the treatment plan.

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Clostridium difficile carriage in healthy pregnant women in China

Cited by 10 publications

References 18 publications

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

Molecular epidemiology and antimicrobial susceptibility of Clostridium difficile isolated from the Chinese People’s Liberation Army General Hospital in China

Characteristics of Clostridioides difficile infection in inflammatory bowel disease

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