Cui Qing-Qing, Yang Jing, Niu Ya-Nan, Qiang Cui-Xin, Li Zhi-Rong, Xu Kai-Yue, Li Ru-Xin, Shi Dong-Yan, Wei Hong-Lian, Zhao Xing-Zhen, Wang Xiao-Ming, Sun Su-Ju, Zhao Jian-Hong
Hebei Provincial Center for Clinical Laboratories, Second Hospital of Hebei Medical University, Shijiazhuang City, Hebei Province, China.
Department of Clinical Laboratory, Second Hospital of Hebei Medical University, Shijiazhuang City, Hebei Province, China.
Anaerobe. 2019 Apr;56:116-123. doi: 10.1016/j.anaerobe.2019.01.008. Epub 2019 Mar 5.
Clostridioides difficile is a colonizer of the human gut; asymptomatic colonization has been reported to be more common in infants and is highly variable across regions even with no symptoms of diarrhea or death. Antibiotic treatment strategies might increase the antibiotic resistance of C. difficile. We performed a one-point study involving 1098 healthy infants (0-36 months) to address the deficiency of reports on C. difficile colonization in Chinese community infants. The C. difficile colonization rate was 22.8% (250/1098), and more than half of the strains (55.2%) were toxigenic isolates. Among the 138 toxigenic isolates, 111 were of the ABCDT genotype, 26 strains were ABCDT, and one strain was ABCDT. Fifteen different PCR ribotypes were found among the 250 isolates, and PCR-ribotype HB03 appeared to be dominant type, accounting for 19.6% (49/250). High levels of resistance to antimicrobial agents were observed. Our study showed that age and hospitalization before stool collection were positively correlated with the C. difficile colonization rate, whereas the delivery term was negatively related to the colonization rate. Particular attention should be paid to the increasing resistance of C. difficile to rifamycin.
艰难梭菌是人类肠道的定植菌；据报道，无症状定植在婴儿中更为常见，并且即使没有腹泻或死亡症状，不同地区的无症状定植情况也存在很大差异。抗生素治疗策略可能会增加艰难梭菌的耐药性。我们开展了一项针对1098名健康婴儿（0至36个月）的单点研究，以解决中国社区婴儿艰难梭菌定植报告的不足问题。艰难梭菌定植率为22.8%（250/1098），超过半数的菌株（55.2%）为产毒分离株。在138株产毒分离株中，111株为ABCDT基因型，26株为ABCDT，1株为ABCDT。在250株分离株中发现了15种不同的PCR核糖体分型，其中PCR核糖体分型HB03似乎是优势型，占19.6%（49/250）。观察到对抗菌药物的高耐药水平。我们的研究表明，年龄和粪便采集前的住院情况与艰难梭菌定植率呈正相关，而分娩孕周与定植率呈负相关。应特别关注艰难梭菌对利福霉素耐药性增加的问题。
