Molecular Epidemiology and Antimicrobial Susceptibility of Clostridium difficile Isolates from a University Teaching Hospital in China

While the developed world has seen a significant increase in the number of scientific articles on infection (CDI), the developing world still lags behind on this subject due to limited laboratory capacity, low awareness, and limited surveillance of this problem. As such, CDI is considered a neglecte...

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Published inFrontiers in microbiology Vol. 7; p. 1621
Main Authors Cheng, Jing-Wei, Xiao, Meng, Kudinha, Timothy, Kong, Fanrong, Xu, Zhi-Peng, Sun, Lin-Ying, Zhang, Li, Fan, Xin, Xie, Xiu-Li, Xu, Ying-Chun
Format Journal Article
LanguageEnglish
Published Switzerland Frontiers Media S.A 17.10.2016
Subjects
antimicrobial resistance
China
Clostridium difficile
Microbiology
Molecular Typing
surveillance
surveillance
antimicrobial resistance
China
Clostridium difficile
molecular typing
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Summary:While the developed world has seen a significant increase in the number of scientific articles on infection (CDI), the developing world still lags behind on this subject due to limited laboratory capacity, low awareness, and limited surveillance of this problem. As such, CDI is considered a neglected but potentially huge problem in developing countries. The major aim of this study was to systemically evaluate the utility of several molecular typing tools for CDI, including their relevance in epidemiological studies in developing countries such as China. A total of 116 non-repetitive toxigenic isolates from Chinese patients, were studied. The isolates comprised 83 (71.6%) A+B+CDT- isolates, 27 (23.3%) A-B+CDT- isolates, and 6 (5.1%) A+B+CDT+ isolates. Typing methods evaluated included multilocus variable-number tandem-repeat analysis, PCR ribotyping, multilocus sequence typing, and sequencing of and genes, which identified 113, 30, 22, 18, and 8 genotypes each and exhibited discriminatory powers of 0.999, 0.916, 0.907, 0.883, and 0.765, respectively. Compared to A+B+ strains, A-B+ strains exhibited higher prevalence of drug resistance to clindamycin, erythromycin, levofloxacin, rifampicin, rifaximin, and tetracycline. Furthermore, drug resistance rates of strains with different PCR ribotypes differed, supporting the importance of molecular typing in management and control of CDI. Based on our earlier suggestion to improve the diagnostic laboratory capacity of CDI in developing countries, setting up efficient surveillance programs complemented by relevant molecular typing methods is warranted.
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This article was submitted to Infectious Diseases, a section of the journal Frontiers in Microbiology
Reviewed by: Jozsef Soki, University of Szeged, Hungary; Shijian Zhang, Dana-Farber Cancer Institute, USA
Edited by: Fatah Kashanchi, George Mason University, USA
These authors have contributed equally to this work.
ISSN:1664-302X
1664-302X
DOI:10.3389/fmicb.2016.01621