Different molecular characteristics and antimicrobial resistance profiles of
            <i>Clostridium difficile</i>
            in the Asia-Pacific region

Luo, Yun; Cheong, Elaine; Bian, Qiao; Collins, Deirdre A.; Ye, Julian; Shin, Jeong Hwan; Yam, Wing Cheong; Takata, Tohru; Song, Xiaojun; Wang, Xianjun; Kamboj, Mini; Gottlieb, Thomas; Jiang, Jianmin; Riley, Thomas V.; Tang, Yi‐Wei; Jin, Dazhi

doi:10.1080/22221751.2019.1682472

Cited by 21 publications

(21 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this retrospective study, we collected all C. difficile strains isolated in a general teaching hospital in Shanghai, China over a period of 5 years from September 2014 to August 2019 to investigate the molecular epidemiology and risk factors for the most prevalent genotype infection. Unlike the previously reported predominant clones of C. difficile isolates elsewhere in China, which were ST37, followed by ST54, ST3, ST2, and ST35 (Huang et al, 2009;Hawkey et al, 2013;Luo et al, 2019), we observed that ST81 was the major ST type in Renji Hospital in Shanghai, China for these 5 years, indicating a geographical diversity of molecular typing. Notably, a growing trend of ST81 clone in Beijing has been reported recently (Cheng et al, 2020), while another study on C. difficile colonization in patients admitted to an intensive care unit in Shanghai demonstrated a predominant role of ST81 genotype (Cui et al, 2019).…”

Section: Discussioncontrasting

confidence: 99%

Molecular Epidemiology and Risk Factors of Clostridium difficile ST81 Infection in a Teaching Hospital in Eastern China

Yang

Huang

Qin

et al. 2020

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

BackgroundThe prevalence of Clostridium difficile causes an increased morbidity and mortality of inpatients, especially in Europe and North America, while data on C. difficile infection (CDI) are limited in China.MethodsFrom September 2014 to August 2019, 562 C. difficile isolates were collected from patients and screened for toxin genes. Multilocus sequence typing (MLST) and antimicrobial susceptibility tests by E-test and agar dilution method were performed. A case group composed of patients infected with sequence type (ST) 81 C. difficile was compared to the non-ST81 infection group and non CDI diarrhea patients for risk factor and outcome analyses.ResultsThe incidence of inpatients with CDI was 7.06 cases per 10,000 patient-days. Of the 562 C. difficile isolates, ST81(22.78%) was the predominant clone over this period, followed by ST54 (11.21%), ST3 (9.61%), and ST2 (8.72%). Toxin genotype tcdA+tcdB+cdt- accounted for 50.18% of all strains, while 29.54% were tcdA-tcdB+cdt- genotypes. Overall, no isolate was resistant to vancomycin, teicoplanin or daptomycin, and resistance rates to meropenem gradually decreased during these years. Although several metronidazole-resistant strains were isolated in this study, the MIC values decreased during this period. Resistance rates to moxifloxacin and clindamycin remained higher than those to the other antibiotics. Among CDI inpatients, longer hospitalization, usage of prednisolone, suffering from chronic kidney disease or connective tissue diseases and admission to emergency ward 2 or emergency ICU were significant risk factors for ST81 clone infection. All-cause mortality of these CDI patients was 4.92%(n=18), while the recurrent cases accounted for 5.74%(n=21). The 60-day mortality of ST81-CDI was significantly higher than non-ST81 infected group, while ST81 also accounted for most of the recurrent CDI cases.ConclusionThis study revealed the molecular epidemiology and risk factors for the dominant C. difficile ST81 genotype infection in eastern China. Continuous and stringent surveillance on the emerging ST81 genotype needs to be initiated.

show abstract

Section: Discussioncontrasting

confidence: 99%

Molecular Epidemiology and Risk Factors of Clostridium difficile ST81 Infection in a Teaching Hospital in Eastern China

Yang

Huang

Qin

et al. 2020

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

show abstract

“…Importantly, pig and calf were thought to be the predominant animals carrying C. difficile isolates. However, such kind of study is quite limited in China, although there are many molecular studies of clinical C. difficile in China, even in the Asia-Pacific area [20,21]. Until now, there is only one report on C. difficile from pig, chicken and duck in China in 2019, but calf was not included [12].…”

Section: Discussionmentioning

confidence: 99%

The molecular characters and antibiotic resistance of Clostridioides difficile from economic animals in China

Zhang

Liu

et al. 2020

BMC Microbiol

View full text Add to dashboard Cite

Background: It has been performed worldwidely to explore the potential of animals that might be a reservoir for community associated human infections of Clostridioides difficile. Several genetically undistinguished PCR ribotypes of C. difficile from animals and human have been reported, illustrating potential transmission of C. difficile between them. Pig and calf were considered as the main origins of C. difficile with predominant RT078 and RT033, respectively. As more investigations involved, great diversity of molecular types from pig and calf were reported in Europe, North American and Australia. However, there were quite limited research on C. difficile isolates from meat animals in China, leading to non-comprehensive understanding of molecular epidemiology of C. difficile in China. Results: A total of 55 C. difficile were isolated from 953 animal stool samples, within which 51 strains were from newborn dairy calf less than 7 days in Shandong Province. These isolates were divided into 3 STs and 6 RTs, of which ST11/RT126 was predominant type, and responsible for majority antibiotic resistance isolates. All the isolates were resistant to at least one tested antibiotics, however, only two multidrug resistant (MDR) isolates were identified. Furthermore, erythromycin (ERY) and clindamycin (CLI) were the two main resistant antibiotics. None of the isolates were resistant to vancomycin (VAN), metronidazole (MTZ), tetracycline (TET), and rifampin (RIF). Conclusions: In this study, we analyzed the prevalence, molecular characters and antibiotic resistance of C. difficile from calf, sheep, chicken, and pig in China. Some unique features were found here: first, RT126 not RT078 were the dominant type from baby calf, and none isolates were got from pig; second, on the whole, isolates from animals display relative lower resistant rate to these 11 tested antibiotics, compared with isolates from human in China in our previous report. Our study helps to deep understanding the situation of C. difficile from economic animals in China, and to further study the potential transmission of C. difficile between meat animals and human.

show abstract

“…However, there were no any data supporting the standard of CDI diagnosis for children in China. The diversity of individual gut microbiomes was distinctly different among human beings from different geographical regions [47], and stewardship of antimicrobial use was implemented at different [48]. Thus, it was speculated that the principle of CDI test for children under 1 year might be differentiated in China.…”

Section: Discussionmentioning

confidence: 99%

Molecular characteristics of Clostridium difficile in children with acute gastroenteritis from Zhejiang

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background: Clostridium difficile infection (CDI) has an increasing pediatric prevalence worldwide. However, molecular characteristics of C. difficile in Chinese children with acute gastroenteritis have not been reported. Methods: A five-year cross-sectional study was conducted in a tertiary children's hospital in Zhejiang. Consecutive stool specimens from outpatient children with acute gastroenteritis were cultured for C. difficile, and isolates then were analyzed for toxin genes, multi-locus sequence type and antimicrobial resistance. Diarrhea-related viruses were detected, and demographic data were collected. Results: A total of 115 CDI cases (14.3%), and 69 co-infected cases with both viruses and toxigenic C. difficile, were found in the 804 stool samples. The 186 C. difficile isolates included 6 of toxin A-positive/toxin B-positive/binary toxin-positive (A + B + CDT +), 139 of A + B + CDT − , 3 of A − B + CDT + , 36 of A − B + CDT − and 2 of A − B − CDT −. Sequence types 26 (17.7%), 35 (11.3%), 39 (12.4%), 54 (16.7%), and 152 (11.3%) were major genotypes with significant differences among different antimicrobial resistances (Fisher's exact test, P < 0.001). The A − B + isolates had significantly higher resistance, compared to erythromycin, rifampin, moxifloxacin, and gatifloxacin, than that of the A + B + (χ 2 = 7.78 to 29.26, P < 0.01). The positive CDI rate in infants (16.2%) was significantly higher than that of children over 1 year old (10.8%) (χ 2 = 4.39, P = 0.036). Conclusions: CDI has been revealed as a major cause of acute gastroenteritis in children with various genotypes. The role of toxigenic C. difficile and risk factors of CDI should be emphatically considered in subsequent diarrhea surveillance in children from China.

show abstract

Different molecular characteristics and antimicrobial resistance profiles of Clostridium difficile in the Asia-Pacific region

Cited by 21 publications

References 40 publications

Molecular Epidemiology and Risk Factors of Clostridium difficile ST81 Infection in a Teaching Hospital in Eastern China

Molecular Epidemiology and Risk Factors of Clostridium difficile ST81 Infection in a Teaching Hospital in Eastern China

The molecular characters and antibiotic resistance of Clostridioides difficile from economic animals in China

Molecular characteristics of Clostridium difficile in children with acute gastroenteritis from Zhejiang

Contact Info

Product

Resources

About