Characteristics of Clostridium difficile strains isolated from asymptomatic individuals and from diarrheal patients

Wongwanich, Siripan; Pongpech, Pintip; Dhiraputra, Chertsak; Huttayananont, Sriwanna; Sawanpanyalert, Pathom

doi:10.1046/j.1198-743x.2001.00308.x

Cited by 19 publications

(22 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In 2001, Wongwanich et al. [15] reported the prevalence of C. difficile among adult patients to be 25.0% (33/132) and that of toxigenic strains to be 13.6% (18/132). Although the prevalence of toxigenic C. difficile was slightly higher than that observed in the current study, it is still likely to be an underestimation at the time, as the authors only investigated the presence of tcdA.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and molecular epidemiology of Clostridium difficile infection in Thailand

Putsathit

Maneerattanaporn

Piewngam

et al. 2017

New Microbes and New Infections

View full text Add to dashboard Cite

Little is known about Clostridium difficile infection (CDI) in Asia generally, and specifically in Thailand. Given the high prevalence of inappropriate antibiotic usage in this region, CDI is likely to be common. This study investigated the prevalence and molecular epidemiology of CDI in Thailand. Stool specimens collected from inpatients with diarrhoea at Siriraj hospital in Bangkok (n = 422) were cultured on ChromID Cdiff agar and any presumptive C. difficile colonies were identified, PCR ribotyped and toxin profiled. As part of the routine C. difficile testing at Siriraj Hospital, 370 specimens also underwent testing with the BD MAX Cdiff assay to detect the presence of tcdB. With direct culture, 105 different isolates of C. difficile were recovered from 23.7% (100/422) of the stool specimens. The prevalence of toxigenic and nontoxigenic isolates was 9.2% (39/422) and 15.6% (66/422), respectively. Of the toxigenic isolates, 69.2% (27/39) and 30.8% (12/39) were tcdA and tcdB positive (A+B+), and A−B+, respectively; none contained binary toxin genes. The five most prevalent ribotypes (RTs) were 014/020 group (17/105), 010 (12/105), 017 (12/105), 039 (9/105) and 009 (6/105). Using toxigenic culture as the reference standard, the sensitivity, specificity, positive predictive value and negative predictive value of the BD MAX Cdiff assay were 68.6, 95.1, 63.2 and 96.1%, respectively. The high proportion of A−B+, RT 017 strains emphasises the need for diagnostic tests that detect either both toxins or just tcdB. Continued surveillance that involves stool culturing will allow molecular tracking and assist in elucidating the epidemiology of CDI in Thailand.

show abstract

Section: Discussionmentioning

confidence: 99%

Prevalence and molecular epidemiology of Clostridium difficile infection in Thailand

Putsathit

Maneerattanaporn

Piewngam

et al. 2017

New Microbes and New Infections

View full text Add to dashboard Cite

show abstract

“…This strain was responsible for a high proportion (19.4 %) of C. difficile toxin positive stools in symptomatic children in a recent study in the USA [52]. A study of hospitalised but asymptomatic children in Thailand demonstrated relatively high carriage rates for C. difficile (11.0 % of infants, and 21.1 % of 1-11 year olds) but low rates of toxin A gene detection (0.9 % of infants and none of the older children; toxin B not tested) [53]. 87.2 % of the strains isolated in asymptomatic children in the Japanese day-care study were also non-toxigenic ( tcdA−/tcdB−) [13].…”

Section: Explanations For High Levels Of Asymptomatic Colonisationmentioning

confidence: 92%

Clostridium difficile in Children: A Review of Existing and Recently Uncovered Evidence

Morris

Tebruegge

Pallett

et al. 2012

Advances in Experimental Medicine and Biology

View full text Add to dashboard Cite

The clinical significance of the presence of Clostridium difficile in children's faeces remains uncertain using current diagnostic procedures. Clostridium difficile is a relatively common finding in infants with no symptoms of gastrointestinal disease, suggesting it may be an incidental finding and form part of the normal gut micro-flora in this age group. On the other hand, particularly in older children or those with significant co-morbidity, there are examples where C. difficile causes disease and exerts considerable morbidity and even mortality (C. difficile infection, CDI). Between these extremes lie a substantial group of children who have both diarrhoea and C. difficile in their stools but where the nature of the association is not clear: Clostridium difficile associated disease (CDAD). We review the significance of C. difficile in children presenting recently uncovered paediatric data from a large UK epidemiological study that informs some key unanswered questions.

show abstract

“…In this study, tcdA PCR-negative isolates predominated, numbering 57 overall and 18/33 adult diarrhoeal isolates. Fourteen PFGE pulsotypes and eight subtypes were found [57]. No data on circulating ribotypes have been reported.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Clostridium difficile infection in Asia

Collins

Hawkey

Riley

2013

Antimicrob Resist Infect Control

196

178

View full text Add to dashboard Cite

While Clostridium difficile infection (CDI) has come to prominence as major epidemics have occurred in North America and Europe over the recent decade, awareness and surveillance of CDI in Asia have remained poor. Limited studies performed throughout Asia indicate that CDI is also a significant nosocomial pathogen in this region, but the true prevalence of CDI remains unknown. A lack of regulated antibiotic use in many Asian countries suggests that the prevalence of CDI may be comparatively high. Molecular studies indicate that ribotypes 027 and 078, which have caused significant outbreaks in other regions of the world, are rare in Asia. However, variant toxin A-negative/toxin B-positive strains of ribotype 017 have caused epidemics across several Asian countries. Ribotype smz/018 has caused widespread disease across Japan over the last decade and more recently emerged in Korea. This review summarises current knowledge on CDI in Asian countries.

show abstract

Characteristics of Clostridium difficile strains isolated from asymptomatic individuals and from diarrheal patients

Cited by 19 publications

References 17 publications

Prevalence and molecular epidemiology of Clostridium difficile infection in Thailand

Prevalence and molecular epidemiology of Clostridium difficile infection in Thailand

Clostridium difficile in Children: A Review of Existing and Recently Uncovered Evidence

Epidemiology of Clostridium difficile infection in Asia

Contact Info

Product

Resources

About