Dirks Esther E, Luković Jasminka A, Peltroche-Llacsahuanga Heidrun, Herrmann Anke, Mellmann Alexander, Arvand Mardjan
Unit for Hospital Hygiene, Infection Prevention and Control, Department of Infectious Diseases, Robert Koch Institute, 13353 Berlin, Germany.
Institute for Microbiology and Hospital Hygiene, Carl-Thiem-Hospital, 03048 Cottbus, Germany.
Microorganisms. 2022 Dec 22;11(1):44. doi: 10.3390/microorganisms11010044.
(1) Background: infections (CDI) have increased worldwide, and the disease is one of the most common healthcare-associated infections (HAI). This study aimed to evaluate the molecular epidemiology of , the clinical outcome, and the time of initiation of specific hygiene measures in patients with CDI in a large tertiary-care hospital in Brandenburg. (2) Methods: Faecal samples and data from hospitalised patients diagnosed with CDI were analysed from October 2016 to October 2017. The pathogens were isolated, identified as toxigenic , and subsequently subtyped using PCR ribotyping and whole genome sequencing (WGS). Data regarding specific hygiene measures for handling CDI patients were collected. (3) Results: 92.1% of cases could be classified as healthcare-associated (HA)-CDI. The recurrence rate within 30 and 90 days after CDI diagnosis was 15.7% and 18.6%, and the mortality rate was 21.4% and 41.4%, respectively. The most frequent ribotypes (RT) were RT027 (31.3%), RT014 (18.2%), and RT005 (14.1%). Analysis of WGS data using cgMLST showed that all RT027 isolates were closely related; they were assigned to two subclusters. Single-room isolation or barrier measures were implemented in 95.7% patients. (4) Conclusions: These data show that RT027 is regionally predominant, thus highlighting the importance of specific hygiene measures to prevent and control CDI and the need to improve molecular surveillance of at the local and national level.
(1) 背景：艰难梭菌感染（CDI）在全球范围内呈上升趋势，该疾病是最常见的医疗保健相关感染（HAI）之一。本研究旨在评估勃兰登堡一家大型三级医院中CDI患者的分子流行病学、临床结局以及采取特定卫生措施的时间。(2) 方法：分析了2016年10月至2017年10月期间住院诊断为CDI患者的粪便样本和数据。分离病原体，鉴定为产毒艰难梭菌，随后使用PCR核糖体分型和全基因组测序（WGS）进行亚型分析。收集了有关处理CDI患者的特定卫生措施的数据。(3) 结果：92.1%的病例可归类为医疗保健相关（HA）-CDI。CDI诊断后30天和90天内的复发率分别为15.7%和18.6%，死亡率分别为21.4%和41.4%。最常见的核糖体分型（RT）为RT027（31.3%）、RT014（18.2%）和RT005（14.1%）。使用cgMLST对WGS数据进行分析表明，所有RT027分离株密切相关；它们被分为两个亚群。95.7%的患者实施了单人房间隔离或屏障措施。(4) 结论：这些数据表明RT027在该地区占主导地位，从而凸显了预防和控制CDI的特定卫生措施的重要性，以及在地方和国家层面加强艰难梭菌分子监测的必要性。
