Multilocus Variable-Number Tandem-Repeat Analysis for Investigation of
            <i>Clostridium difficile</i>
            Transmission in Hospitals

Marsh, Jane W.; O'Leary, Mary M.; Shutt, Kathleen A.; Pasculle, A. William; Johnson, Stuart; Gerding, Dale N.; Muto, Carlene A.; Harrison, Lee H.

doi:10.1128/jcm.02364-05

Cited by 118 publications

(133 citation statements)

References 33 publications

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“…1) and AFLP results (not shown). Using different MLVA targets and different analytic methods, others have found MLVA to be a useful tool in tracking health care-related C. difficile infections (20).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Seven Techniques for Typing International Epidemic Strains of Clostridium difficile : Restriction Endonuclease Analysis, Pulsed-Field Gel Electrophoresis, PCR-Ribotyping, Multilocus Sequence Typing, Multilocus Variable-Number Tandem-Repeat Analysis, Amplified Fragment Length Polymorphism, and Surface Layer Protein A Gene Sequence Typing

et al. 2008

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Using 42 isolates contributed by laboratories in Canada, The Netherlands, the United Kingdom, and the United States, we compared the results of analyses done with seven Clostridium difficile typing techniques: multilocus variable-number tandem-repeat analysis (MLVA), amplified fragment length polymorphism (AFLP), surface layer protein A gene sequence typing (slpAST), PCR-ribotyping, restriction endonuclease analysis (REA), multilocus sequence typing (MLST), and pulsed-field gel electrophoresis (PFGE). We assessed the discriminating ability and typeability of each technique as well as the agreement among techniques in grouping isolates by allele profile A (AP-A) through AP-F, which are defined by toxinotype, the presence of the binary toxin gene, and deletion in the tcdC gene. We found that all isolates were typeable by all techniques and that discrimination index scores for the techniques tested ranged from 0.964 to 0.631 in the following order: MLVA, REA, PFGE, slpAST, PCR-ribotyping, MLST, and AFLP. All the techniques were able to distinguish the current epidemic strain of C. difficile (BI/027/NAP1) from other strains. All of the techniques showed multiple types for AP-A (toxinotype 0, binary toxin negative, and no tcdC gene deletion). REA, slpAST, MLST, and PCR-ribotyping all included AP-B (toxinotype III, binary toxin positive, and an 18-bp deletion in tcdC) in a single group that excluded other APs. PFGE, AFLP, and MLVA grouped two, one, and two different non-AP-B isolates, respectively, with their AP-B isolates. All techniques appear to be capable of detecting outbreak strains, but only REA and MLVA showed sufficient discrimination to distinguish strains from different outbreaks.

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Section: Discussionmentioning

confidence: 99%

Comparison of Seven Techniques for Typing International Epidemic Strains of Clostridium difficile : Restriction Endonuclease Analysis, Pulsed-Field Gel Electrophoresis, PCR-Ribotyping, Multilocus Sequence Typing, Multilocus Variable-Number Tandem-Repeat Analysis, Amplified Fragment Length Polymorphism, and Surface Layer Protein A Gene Sequence Typing

et al. 2008

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“…For MLVA, five regions with short tandem repeats were sequenced: A6Cd, B7Cd, C6Cd, G8Cd [17] and CDR60 [18], with a change of reverse primer for G8Cd, as described elsewhere [19]. The number of tandem repeats was counted manually after software processing (Sequencing Analysis Software, Applied Biosystems).…”

Section: Methodsmentioning

confidence: 99%

Clostridium difficile PCR ribotypes 001 and 176 – the common denominator of C. difficile infection epidemiology in the Czech Republic, 2014

et al. 2016

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In 2014, 18 hospitals in the Czech Republic participated in a survey of the incidence of Clostridium difficile infections (CDI) in the country. The mean CDI incidence was 6.1 (standard deviation (SD):7.2) cases per 10,000 patient bed-days and 37.8 cases (SD: 41.4) per 10,000 admissions. The mean CDI testing frequency was 39.5 tests (SD: 25.4) per 10,000 patient bed-days and 255.8 tests (SD: 164.0) per 10,000 admissions. A total of 774 C. difficile isolates were investigated, of which 225 (29%) belonged to PCR ribotype 176, and 184 isolates (24%) belonged to PCR ribotype 001. Multilocus variable-number tandem repeat analysis (MLVA) revealed 27 clonal complexes formed by 84% (190/225) of PCR ribotype 176 isolates, and 14 clonal complexes formed by 77% (141/184) of PCR ribotype 001 isolates. Clonal clusters of PCR ribotypes 176 and 001 were observed in 11 and 7 hospitals, respectively. Our data demonstrate the spread of two C. difficile PCR ribotypes within 18 hospitals in the Czech Republic, stressing the importance of standardising CDI testing protocols and implementing mandatory CDI surveillance in the country.

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“…Multilocus variable-number tandem repeat analysis (MLVA) is a well-known typing method that has been successfully developed for many bacterial species or for serovars within a species (Liang et al, 2007;Liao et al, 2006;Lindstedt et al, 2003;Marsh et al, 2006;Noller et al, 2003). Based on the analysis of multilocus variable-number tandem repeats (VNTRs), MLVA can be an extremely powerful method for distinguishing between closely related isolates in the investigation of disease outbreaks (Liang et al, 2007;Noller et al, 2003;Torpdahl et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Use of multilocus variable-number tandem repeat analysis in molecular subtyping of Salmonella enterica serovar Typhi isolates

Tien

Ushijima

Mizuguchi

et al. 2012

Journal of Medical Microbiology

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Multilocus Variable-Number Tandem-Repeat Analysis for Investigation of Clostridium difficile Transmission in Hospitals

Cited by 118 publications

References 33 publications

Clostridium difficile PCR ribotypes 001 and 176 – the common denominator of C. difficile infection epidemiology in the Czech Republic, 2014

Use of multilocus variable-number tandem repeat analysis in molecular subtyping of Salmonella enterica serovar Typhi isolates

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