Roberts Sally, Heffernan Helen, Al Anbuky Nadia, Pope Christopher, Paviour Susan, Camp Tracey, Swager Terri
Department of Microbiology, LabPlus, Auckland District Health Board, Grafton, Auckland, New Zealand.
N Z Med J. 2011 Apr 15;124(1332):45-51.
The aim of this study was to provide baseline information on the molecular epidemiology and the antimicrobial susceptibility of Clostridium difficile (C. difficile) clinical isolates from patients throughout New Zealand.
Faecal specimens that were C. difficile-toxin positive by EIA assay were cultured for C. difficile. Antimicrobial susceptibility testing was carried out using the agar dilution minimum inhibitory concentration method. The following antibiotics were tested: penicillin, piperacillin/tazobactam, vancomycin, ciprofloxacin, moxifloxacin, clindamycin, clarithromycin, meropenem and metronidazole. Molecular typing by PCR-ribotyping was performed on all isolates.
C. difficile was isolated from 108 of 159 submitted faecal specimens. After excluding the repeats, there were 101 isolates from 97 patients. Most isolates were fully susceptible to the range of antibiotics tested. Thirty-two PCR-ribotypes were identified among the 101 isolates. The most common ribotypes were 014 (18 isolates), 002 (11) and 005 (10). No PCR-ribotype 027 isolates were identified, but one isolate of another hypervirulent strain, PCR-ribotype 078, was identified.
There is a wide range of C. difficile PCR-ribotypes circulating in New Zealand and antimicrobial resistance is uncommon. Ongoing surveillance for hypervirulent strains of C. difficile is essential to prevent the dissemination of these strains within New Zealand hospitals.
本研究旨在提供来自新西兰各地患者的艰难梭菌临床分离株的分子流行病学和抗菌药物敏感性的基线信息。
通过酶免疫分析检测艰难梭菌毒素呈阳性的粪便标本，对其进行艰难梭菌培养。采用琼脂稀释最低抑菌浓度法进行抗菌药物敏感性试验。检测的抗生素如下：青霉素、哌拉西林/他唑巴坦、万古霉素、环丙沙星、莫西沙星、克林霉素、克拉霉素、美罗培南和甲硝唑。对所有分离株进行PCR核糖体分型分子分型。
从159份送检粪便标本中的108份中分离出艰难梭菌。排除重复菌株后，有来自97名患者的101株分离株。大多数分离株对所检测的一系列抗生素完全敏感。在101株分离株中鉴定出32种PCR核糖体分型。最常见的核糖体分型是014型（18株）、002型（11株）和005型（10株）。未鉴定出PCR核糖体分型027的分离株，但鉴定出了另一株高毒力菌株PCR核糖体分型078的1株分离株。
新西兰有多种艰难梭菌PCR核糖体分型在传播，且抗菌药物耐药性并不常见。对艰难梭菌高毒力菌株进行持续监测对于防止这些菌株在新西兰医院内传播至关重要。
