Comparison of Common Molecular Typing Methods for Differentiation of Clostridium difficile Strains in the Study of Hospital Acquired Infections

Abstract

Background: Cross-contamination between patients and the medical imaging device is a worldwide concern. In the current study, the ability of different molecular typing methods for differentiation of Clostridium difficile isolates from patients and medical devices was compared to show their discriminatory power for molecular epidemiological purposes. Methods: A total of 23 C. difficile strains from fresh stool samples of patients subjected to colonoscopy, medical device, and environmental samples of a gastroenterology unit were used for molecular typing. Similarity of the strains was determined by the polymerase chain reaction (PCR) ribotyping, capillary gel electrophoresis based-ribotyping, and RAPD-PCR and ERIC-PCR methods. Phylogenetic analysis of the molecular patterns was done by the GelCompar II software and discriminatory power of the methods was measured using Simpson's index diversity. Results: RAPD-PCR and PCR-ribotyping methods showed the highest discrimination power for differentiation of the studied strains, while genotyping showed the lowest power. Similarity of C. difficile strains between the patients and medical equipment was detected for the strains presenting PCR-ribotypes B and CE-ribotype 150. Conclusions: Involvement of medical device for transmission of toxigenic strains of C. difficile was determined in this study. Although diversity of C. difficile strains was established in the studied hospital, a discrepancy was detected among these techniques for typing purposes. The results suggested the usage of a combination of two or more typing methods for detection of sources of cross-contamination in each hospital.

Comparative Assessment of Different PCR-Based Typing Methods of Pseudomonas aeruginosa Isolates

“…AZIMIRAD et al showed that PCR-ribotyping gave high discrimination of isolates as PFGE. 38 Accordingly, our results revealed the high discriminatory power of Ribo-2 (DI=0.969). Collier et al reported that PCR-ribotyping was more discriminating than AP-PCR in differentiating 49 P. aeruginosa isolates.…”

“…41 Azimirad et al reported that RAPD and ERIC were the best markers in discrimination between C. difficile isolates followed by ribotyping. 38 Besides, ribotyping using Ribo-2 primer was able to Infection and Drug Resistance 2021:14 submit your manuscript | www.dovepress.com DovePress differentiate 75% of isolates followed by ERIC (72.72%) and P-640 primer (70%). Oleńska and Małek found that ERIC-PCR can differentiate 61% of 77 rhizobial strains.…”

“…45 Azimirad et al construct a correlation between RAPD, PFGE, and ribotyping in C. difficile isolates, they showed that the same discrimination power was obtained by PFGE and RAPD. 38 In general, various methods were used to characterize P. aeruginosa strains. A vital point is how the use of a single method or combination of methods could provide information as DI, typeability, or ISD of the isolates.…”

<p>Phenotypic and Genotypic Characteristics of <em>Clostridium difficile</em> Isolates in Patients with Type 2 Diabetes in Iran</p>

“…14,19 RAPD fingerprinting can rapidly classify isolates into clusters and the relationship of strains can be determined. 13,19 The RAPD typing showed high discriminatory power and stability for analysis of these strains 29 This method provide reliable results within one or 2 days and allow for early and more precise implementation of infection control measures. 30 Our results strongly suggest that two major RAPD types of C. difficile, isolated from 53.8% (7/13) and 30.8% (4/13) of the patients, were prevalent circulating strains in this studied diabetic population.…”