Epidemiology of Clostridium difficile infection in Asia

Abstract

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.

Comparison of two types of matrix-assisted laser desorption/ionization time-of-flight mass spectrometer for the identification and typing of Clostridium difficile

“…Therefore, we consider that the 50 clinical isolates do not belong to PCR ribotypes 001, 027 or 078, which have recently become globally widespread. Because PCR ribotypes 001, 027 and 078 have not spread to Japan to date (Collins et al, 2013), our results seem reasonable.…”

Clostridium difficile infection: Early history, diagnosis and molecular strain typing methods

“…The results obtained showed that iron fortification in infants adversely affected the gut microbiota, with an increase in the proportion of some pathogenic bacteria, including Escherichia coli, Salmonella, Clostridium perfringens and C. difficile [60]. A review [61] on the epidemiology of C. difficile in Asia shows that infection occurred at similar rates to other areas but with a predominance of variant toxin A and toxin B positive strains, including PCR-ribotypes 017 and 018. In contrast with the situation in America and Europe, PCR-ribotypes 027 and 078 have rarely been reported in Asia.…”

“…In contrast with the situation in America and Europe, PCR-ribotypes 027 and 078 have rarely been reported in Asia. The unregulated use of antibiotics in some Asian regions and the lack of surveillance raise concerns over the risk of bacterial mutation and infection [61]. An additional review describes the situation in Thailand in detail.…”

Prevalence of Clostridium Difficile Among Paediatric Patients in a Tertiary Care Hospital, Coastal Karnataka, South India

“…Estimates regarding the occurrence of C. difficile infection (CDI) in United States per year has been mentioned in a study [3]. A few reports are available regarding the prevalence of CDI in Asian countries [4,5]. The mutant hypervirulent strain, NAP1/BI/027 (North American Pulse-field gel electrophoresis type 1 /restriction endonuclease analysis BI/ribotype 027) which was responsible for the outbreaks of CDAD in many parts of the world has given due significance to the organism [6].…”