Aschbacher Richard, Indra Alexander, Wiedermann Christian J, March Albert, Giacon Bruno, Mian Peter, Bombonato Mirella, Kaneppele Angelika, Sansone Stefano, Burth Johanna, Felici Alessandro, Ebner Franziska, Passler Werner, Lerchner Renelda M, Vedovelli Claudio, Spoladore Greta, Binazzi Raffaella, Pagani Leonardo, Moroder Ludwig, Larcher Clara, Pagani Elisabetta
Laboratory of Microbiology and Virology, Central Hospital of Bolzano, Italy.
Austrian Agency for Health & Food Safety, Vienna, Austria.
Infez Med. 2017 Mar 1;25(1):13-20.
Toxigenic Clostridium difficile is responsible for antibiotic-associated diarrhoea and other diseases. The increasing frequency and severity is attributed to highly-virulent ribotypes such as 027. The aim of the study was to collect epidemiological and molecular data for C. difficile isolates during 2009-2013 in the Central Hospital of Bolzano, Northern Italy. Stool samples from inpatients of the Bolzano Central Hospital were screened for toxins A and B, and C. difficile was cultured and tested for antibiotic susceptibility. PCRs were performed for genes of toxin A, toxin B, binary toxin and ribotyping. During the period 2009-13 from 320 patients (9% of patients tested) at least one stool sample proved positive for C. difficile toxins, and incidences for all hospital inpatients per 10,000 patient days (per 1,000 admissions) varied between 2.2 (1.5) and 4.3 (3.0). Out of 138 isolates (43% of total isolates were studied), 24 different ribotypes were identified. Isolates with ribotype 027 were predominant (38%), followed by 018 (13%) and 607 (10%). Whereas for ribotype 018 a significant decrease was seen during the five-year period, ribotype 027 increased significantly from 0% in 2009 to 64% in 2012, decreasing then to 10% in 2013. Isolates were sensitive to metronidazole and vancomycin, whereas isolates of the three major ribotypes were resistant to moxifloxacin. Our data indicates a significant change in C. difficile incidence rates and ribotype frequencies during the five-year period in the Central Hospital in Bolzano.
产毒艰难梭菌可导致抗生素相关性腹泻及其他疾病。其发病频率和严重程度的增加归因于高毒力核糖体分型，如027型。本研究旨在收集2009年至2013年期间意大利北部博尔扎诺中心医院艰难梭菌分离株的流行病学和分子数据。对博尔扎诺中心医院住院患者的粪便样本进行毒素A和毒素B筛查，培养艰难梭菌并检测其抗生素敏感性。对毒素A、毒素B、二元毒素基因及核糖体分型进行聚合酶链反应（PCR）检测。在2009年至2013年期间，320例患者（占检测患者的9%）至少有一份粪便样本艰难梭菌毒素检测呈阳性，每10000住院日（每1000例入院患者）所有医院住院患者的发病率在2.2（1.5）至4.3（3.0）之间。在138株分离株（占总分离株的43%）中，鉴定出24种不同的核糖体分型。核糖体分型027的分离株占主导（38%），其次是018型（13%）和607型（10%）。虽然在五年期间018型核糖体分型显著减少，但027型核糖体分型从2009年的0%显著增加至2012年的64%，随后在2013年降至10%。分离株对甲硝唑和万古霉素敏感，而三种主要核糖体分型的分离株对莫西沙星耐药。我们的数据表明，在博尔扎诺中心医院的五年期间，艰难梭菌发病率和核糖体分型频率发生了显著变化。
