Sagisaka Yusaku, Ishibashi Miyako, Hosokawa Daisuke, Nakagawa Hikaru, Yonogi Shinya, Minami Kenta, Suzuki Youichi, Ogawa Taku, Ukimura Akira, Nakano Takashi, Komano Jun
Department of Microbiology and Infection Control, Faculty of Pharmacy, Osaka Medical and Pharmaceutical University, 4-20-1 Nasahara, Takatsuki, Osaka, 569-1094, Japan.
Department of Clinical Laboratory, National Hospital Organization Nagoya Medical Center, 1-1, 4-Chome, Sannomaru, Naka-ku, Nagoya, Aichi, 460-0001, Japan.
Sci Rep. 2024 Sep 16;14(1):21559. doi: 10.1038/s41598-024-72252-y.
Clostridioides difficile, a cause of healthcare-associated infections, poses a significant global health threat. This multi-institutional retrospective study focuses on epidemic dynamics, emphasizing minor and toxin-negative clinical isolates through high-resolution genotyping. The genotype of the C. difficile clinical isolates during 2005 to 2022 was gathered from 14 hospitals across Japan (N = 982). The total number of unique genotypes was 294. Some genotypes were identified in every hospital (cross-regional genotypes), while others were unique to a specific hospital or those in close geographic proximity (region-specific genotypes). Notably, a hospital located in a sparsely populated prefecture exhibited the highest prevalence of region-specific genotypes. The isolation rate of cross-regional genotypes positively correlated with the human mobility flow. A 6-month interval analysis at a university hospital from 2019 to 2021 revealed a temporal transition of the genotype dominance. The frequent isolation of identical genotypes over a brief timeframe did not always align with the current criteria for defining nosocomial outbreaks. This study highlights the presence of diverse indigenous C. difficile strains in regional environments. The cross-regional strains may have a higher competency to spread in the human community. The longitudinal analysis underscores the need for further investigation into potential nosocomial spread.
艰难梭菌是医疗保健相关感染的一个病因，对全球健康构成重大威胁。这项多机构回顾性研究聚焦于流行动态，通过高分辨率基因分型着重研究轻度和毒素阴性临床分离株。收集了2005年至2022年期间日本14家医院（N = 982）的艰难梭菌临床分离株的基因型。独特基因型的总数为294种。有些基因型在每家医院都有发现（跨区域基因型），而其他基因型则是特定医院或地理位置相近的医院所特有的（区域特异性基因型）。值得注意的是，位于人口稀少县的一家医院区域特异性基因型的患病率最高。跨区域基因型的分离率与人口流动呈正相关。对一所大学医院2019年至2021年进行的为期6个月的间隔分析揭示了基因型优势的时间转变。在短时间内频繁分离出相同基因型并不总是符合当前定义医院感染暴发的标准。这项研究凸显了区域环境中存在多种本土艰难梭菌菌株。跨区域菌株可能具有更强的在人群中传播的能力。纵向分析强调需要进一步调查潜在的医院内传播情况。
