采用多位点可变数目串联重复分析、全基因组多位点序列分型和核心基因组单核苷酸多态性分型对艰难梭菌 PCR-核糖型 018 进行的局部暴发调查。
Local outbreak of Clostridioides difficile PCR-Ribotype 018 investigated by multi locus variable number tandem repeat analysis, whole genome multi locus sequence typing and core genome single nucleotide polymorphism typing.
机构信息
National Reference Laboratory for Clostridium Difficile, Hôpital Saint-Antoine, 34, Rue Crozatier, Paris, France; Université Paris Descartes, Faculté de Pharmacie, Inserm UMR S-1139, 4 Avenue de l'Observatoire, 75006, Paris, France.
Equipe Opérationnelle D'Hygiène, CHU de Strasbourg, 1, Place de l'Hôpital, 67091, Strasbourg, France.
出版信息
Anaerobe. 2019 Dec;60:102087. doi: 10.1016/j.anaerobe.2019.102087. Epub 2019 Aug 13.
The prevalence of Clostridioides difficile PCR-ribotype (RT) 018 is low in Europe but variations are observed across countries. We report here the first RT 018-related outbreak in France that took place in 4 geriatric units (GU) in Strasbourg, France. From January to December 2017, 38 patients were diagnosed with C. difficile infection (CDI). Strains were first characterized by PCR ribotyping: 19 out of 38 (50%) strains belonged to RT 018. These strains as well as 12 RT 018 isolated in other French healthcare facilities and 2 strains of RT 018 isolated in the GU in 2015 were characterized by multi locus variable-number tandem repeat (VNTR) analysis (MLVA), whole genome multi locus sequence typing (wgMLST) and core genome single nucleotide polymorphism typing (cgSNP). The MLVA indicated that 15 out of 19 epidemic strains of RT 018 were included in 2 Clonal Complexes (CC). Four RT 018 strains from the outbreak did not belong to the CC. The wgMLST and cgSNP typing analysis revealed a single CC that included 19 strains from the geriatric unit (17 from GU in 2017 and 2 from GU in 2015) and 4 strains (33%) from other healthcare facilities (HCF). Our results suggest that a specific RT 018 clone has spread in the geriatric unit and has evolved slowly over time. MLVA, wgMLST and cgSNP typing results provided fairly consistent information but wgMLST and cgSNP typing better separated epidemic strains from non-epidemic strains. Compared to wgMLST, the cgSNP typing did not provide additional information.
艰难梭菌 PCR-核糖型（RT）018 在欧洲的流行率较低，但各国之间存在差异。我们在此报告法国首例 RT 018 相关暴发，发生在法国斯特拉斯堡的 4 个老年病房（GU）。2017 年 1 月至 12 月，38 名患者被诊断患有艰难梭菌感染（CDI）。首先通过 PCR 核糖型对菌株进行特征描述：38 株中有 19 株（50%）属于 RT 018。这些菌株以及在其他法国医疗机构分离的 12 株 RT 018 菌株和 2015 年 GU 中分离的 2 株 RT 018 菌株通过多位点可变数目串联重复（VNTR）分析（MLVA）、全基因组多位点序列分型（wgMLST）和核心基因组单核苷酸多态性分型（cgSNP）进行特征描述。MLVA 表明，19 株流行的 RT 018 菌株中有 15 株属于 2 个克隆复合体（CC）。暴发中的 4 株 RT 018 菌株不属于 CC。wgMLST 和 cgSNP 分型分析显示，一个单独的 CC 包括来自老年病房（2017 年的 17 株和 2015 年的 2 株）的 19 株菌株和来自其他医疗机构（HCF）的 4 株菌株（33%）。我们的结果表明，特定的 RT 018 克隆已在老年病房中传播，并随着时间的推移缓慢进化。MLVA、wgMLST 和 cgSNP 分型结果提供了相当一致的信息，但 wgMLST 和 cgSNP 分型更好地将流行株与非流行株区分开来。与 wgMLST 相比，cgSNP 分型没有提供额外的信息。
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