Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, South Korea.
Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, South Korea.
Anaerobe. 2019 Dec;60:102086. doi: 10.1016/j.anaerobe.2019.102086. Epub 2019 Aug 9.
There have been few available data that presented a direct comparison between polymerase chain reaction ribotype (RT) distribution of Clostridioides difficile strains from C. difficile infection (CDI) and colonization. To understand the epidemiology of CDI in a hospital setting, we compared RTs of C. difficile strains from hospital-acquired CDI (HA-CDI) and toxigenic colonization and from community-acquired CDI (CA-CDI) and non-toxigenic colonization using the stool samples submitted for C. difficile cultures at an institution during 2009, 2012, and 2014. Overall, 721 C. difficile strains were identified from 607 patients. Among them, 450 (62.4%) were HA-CDI, 20 (2.8%) were CA-CDI, 126 (17.5%) were toxigenic colonization, and 125 (17.3%) were non-toxigenic colonization. RT018, RT017, RT002, RT015, and RT001 isolates were the most prevalent RTs in HA-CDI, and they comprised 74.9% of the total HA-CDI isolates but accounted for 60.4% of isolates from toxigenic colonization. In total, 32 strain compromising 18 RTs from HA-CDI (7.1%) were not seen among the toxigenic colonization group, and 3 RTs with 5 strains from toxigenic colonization were not seen among the HA-CDI group. The distribution of RTs was the most diverse in CA-CDI and the least diverse in HA-CDI. Although 5 RT strains, which were prevalent in HA-CDI, comprised 40% of CA-CDI, 5 isolates (25%) revealed unknown RTs, which were uncommon in HA-CDI or toxigenic colonization. In 12 patients with both episodes of CDI and toxigenic colonization, 8 had 2 isolates with different RTs and 4 had isolates with identical RTs. In conclusion, although RT017 and RT018 were the most common in HA-CDI and toxigenic colonization, C. difficile strains from toxigenic colonization were more diverse than those from HA-CDI.
已有很少的数据直接比较艰难梭菌（C. difficile）菌株的聚合酶链反应核糖型（RT）分布，这些数据来自艰难梭菌感染（CDI）和定植。为了了解医院环境中 CDI 的流行病学，我们比较了 2009 年、2012 年和 2014 年在一家机构提交的艰难梭菌培养粪便样本中，医院获得性 CDI（HA-CDI）和产毒定植与社区获得性 CDI（CA-CDI）和非产毒定植的 C. difficile 菌株的 RT。总共从 607 名患者中鉴定出 721 株艰难梭菌。其中，450 株（62.4%）为 HA-CDI，20 株（2.8%）为 CA-CDI，126 株（17.5%）为产毒定植，125 株（17.3%）为非产毒定植。RT018、RT017、RT002、RT015 和 RT001 分离株是 HA-CDI 中最常见的 RT，它们占总 HA-CDI 分离株的 74.9%，但占产毒定植分离株的 60.4%。总共有 32 株来自 HA-CDI 的菌株，由 18 种 RT 组成（7.1%），在产毒定植组中未见，而来自产毒定植组的 3 种 RT 中有 5 株未见 HA-CDI 组。RT 的分布在 CA-CDI 中最为多样，在 HA-CDI 中最为多样。虽然在 HA-CDI 中流行的 5 种 RT 菌株占 CA-CDI 的 40%，但 5 株（25%）显示出未知 RT，这些 RT 在 HA-CDI 或产毒定植中并不常见。在 12 例 CDI 和产毒定植的患者中，8 例有 2 株不同 RT 的分离株，4 例有相同 RT 的分离株。总之，尽管 RT017 和 RT018 在 HA-CDI 和产毒定植中最为常见，但产毒定植的艰难梭菌菌株比 HA-CDI 中的菌株更为多样。
