Characteristics of Clostridium difficile isolates and the burden of hospital-acquired Clostridium difficile infection in a tertiary teaching hospital in Chongqing, Southwest China

Abstract

Background: Clostridium difficile infection (CDI), especially hospital-acquired Clostridium difficile infection (HA-CDI), continues to be a public health problem and has aroused great concern worldwide for years. This study aimed to elucidate the clinical and epidemiological features of HA-CDI and the characteristics of C.difficile isolates in Chongqing, Southwest China.Methods: A case-control study was performed to identify the clinical incidence and risk factors of HA-CDI. C. difficile isolates were characterised by polymerase chain reaction (PCR) ribotyping, multilocus sequence typing (MLST), toxin gene detection and antimicrobial susceptibility testing.Results: Of the 175 suspicious patients, a total of 122 patients with antibiotic-associated diarrhea (AAD) were included in the study; among them, 38 had HA-CDI. The incidence of AAD and HA-CDI was 0.58 and 0.18 per 1000 patient admissions, respectively. Chronic renal disease and cephalosporin use were independent risk factors for HA-CDI. Fifty-five strains were assigned into 16 sequence types (STs) and 15 ribotypes (RTs). ST2/RT449 (8, 14.5%) was the predominant genotype. Of the 38 toxigenic isolates, A + B + CDT-isolates accounted for most (34, 89.5%) and 1 A + B + CDT+ isolate emerged. No isolate was resistant to vancomycin, metronidazole or tigecycline, with A-B-CDTbeing more resistant than A + B + CDT-.Conclusions: Different genotypes of C. difficile strains were witnessed in Chongqing, which hinted at the necessary surveillance of HA-CDI. Adequate awareness of patients at high risk of HA-CDI acquisition is advocated and cautious adoption of cephalosporins should be highlighted.

Nosocomial Diarrhea in Intensive Care Units: A Mortality-Based Bacteriological Study

“…The VIDAS GDH assay is useful for the initial screening of C. difficile. Current findings were consistent with those of Borali and Giacomo 20 , Pechal et al 21 and Dai et al 17 that age, treatment with cephalosporins, clindamycin, or broad-spectrum penicillin are associated with an increased risk of AAD. However, gender was not associated with a difference in AAD frequency.…”

“…Zahar et al 15 reported that CDI was responsible for 14.5% of cases of nosocomial diarrhea by ELISA testing and culture. C. diff strains were isolated in 11% of adult patients, as reported by Karanika et al 16 , but Dai et al 17 reported that the incidence of CDI was almost 31% of the total patients who developed AAD. These variations likely arise from differences in population selection and the sensitivity of laboratory tests.…”

Molecular epidemiology and antimicrobial resistance patterns of Clostridioides difficile isolates in Algerian hospitals

“…The three isolates of RT 085 were detected in three different wards of the same hospital in the eastern province of Algeria (Batna), but were missing in the two other provinces; suggesting a possible distinct geographic distribution of this ribotype in Algeria. Although, the ribotype RT 085 was reported as more common in China [33], it was rarely reported in other countries.…”

Розробка Cелективного Середовища Для Виділення Токсин Продукуючих Штамів C. Difficile

“…У країнах Азії, зокрема у Китаї, останні дослідження показують таку саму захворюваність на CDI, як і в європейських країнах. Нові дослідження, проведені показали захворюваність CDI на рівні 31,1 % [7]. В Україні офіційна реєстрація CDI відсутня, тому відсутні і офіційні показники захворюваності, а також смертності.…”