School of Pathology and Laboratory Medicine, University of Western Australia, Crawley, Australia
Department of Microbiology, PathWest Laboratory Medicine, Nedlands, Australia.
J Clin Microbiol. 2018 May 25;56(6). doi: 10.1128/JCM.00170-18. Print 2018 Jun.
Accumulating evidence shows a high prevalence of in Southeast Asia associated with a range of clinical presentations. However, severe infections are rarely reported. We investigated infection (CDI) across four hospitals in Kuala Lumpur and Kota Bharu, Malaysia. Enzyme immunoassays for glutamate dehydrogenase (GDH) and toxin A or B were performed on diarrheal stool specimens collected from patients in 2015 and 2016. Specimens were also cultured and isolates of characterized by PCR ribotyping and detection of toxin genes. In total, 437 specimens were collected and fecal toxin was detected in 3.0%. A further 16.2% of specimens were GDH positive and toxin negative. After culture, toxigenic strains were isolated from 10.3% and nontoxigenic strains from 12.4% of specimens. The most prevalent PCR ribotypes (RTs) were RT 017 (20.0%) and RT 043 (10.0%). The high prevalence of RT 017 and nontoxigenic strains in Malaysia and in neighboring Thailand and Indonesia suggests that they localize to the region of Southeast Asia, with an implication that they may mediate the burden of CDI in the region.
越来越多的证据表明，东南亚地区的发病率很高，与多种临床表现相关。然而，严重感染的病例却很少见。我们调查了马来西亚吉隆坡和哥打巴鲁的四家医院的艰难梭菌感染（CDI）情况。2015 年和 2016 年，我们收集了腹泻患者的粪便标本，并用酶联免疫吸附试验（GDH）和毒素 A 或 B 检测了这些标本。我们还对标本进行了培养，并通过 PCR 核糖体分型和毒素基因检测对 进行了鉴定。总共收集了 437 份标本，粪便毒素检测阳性率为 3.0%。进一步的检测发现，16.2%的标本 GDH 阳性而毒素阴性。经过培养，从 10.3%的标本中分离出了产毒菌株，从 12.4%的标本中分离出了非产毒菌株。最常见的 PCR 核糖体分型（RT）是 RT 017（20.0%）和 RT 043（10.0%）。马来西亚以及邻国泰国和印度尼西亚的 RT 017 和非产毒菌株的高流行率表明它们局限于东南亚地区，这意味着它们可能在该地区介导了 CDI 的负担。
