Molecular epidemiology and antimicrobial susceptibility of Clostridium difficile isolated from hospitals during a 4-year period in China

Chen, Yunbo; Gu, Silan; Shen, Ping; Lv, Tao; Fang, Yanran; Tang, Lingling

doi:10.1099/jmm.0.000646

Cited by 38 publications

(37 citation statements)

References 41 publications

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“…Analyses of sequences were made in Unipro UGENE 1.28 (UniPro, Russia), and MLST profiles were obtained from the public database (https://pubmlst.org/cdifficile/). Three ribotypes (RTs) and strain types (STs) ( Table 1), which have all been described in human patients with CDI around the world, were obtained [32,33]. Our results corroborate the findings of recent studies, which have shown substantial similarities between human and dog C. difficile isolates, suggesting possible zoonotic transmission [34,35].…”

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confidence: 88%

Clostridioides difficile infection in dogs with chronic-recurring diarrhea responsive to dietary changes

et al. 2018

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Five dogs with chronic-recurring diarrhea were positive for Clostridioides difficile infection (CDI), but were unresponsive to treatment with metronidazole. One of these animals was subjected to a colonoscopy, which revealed eosinophilic infiltration of the colon. All five animals completely recovered after dietary changes. The present work suggests that CDI might occur in dogs with other intestinal alterations. In addition, this report suggests that dysbiosis should be considered in animals that have chronic-recurring diarrhea and test positive for C. difficile.

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confidence: 88%

Clostridioides difficile infection in dogs with chronic-recurring diarrhea responsive to dietary changes

et al. 2018

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“…It was confirmed that patients in the CDI group had a prolonged hospital stay. In a previous study, ST-35 and ST-3 were among the most prevalent types in the hospital (21), and were the two predominant types in this study. The current researchers speculated that transmission events may exist, although discriminatory bacterial typing techniques, such as whole genome sequencing, are needed to validate these findings.…”

Section: Discussionsupporting

confidence: 67%

Clostridium difficile Infection Among Hospitalized Chronic Hepatitis B Virus-Infected Patients in a Chinese Hospital

Chen

Gui

et al. 2018

Jundishapur J Microbiol

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Background: Liver disease represents a risk factor for Clostridium difficile infection (CDI). However, CDI predisposition and its incidence in patients with chronic hepatitis B (CHB) have not been well-characterized. Objectives: This study aimed at determining the incidence and risk factors of CDI in CHB patients without cirrhosis. Methods: A retrospective case-control study was conducted on hospitalized patients in a Chinese tertiary hospital between June 2010 and June 2016. Results: A total of 105 CHB patients without cirrhosis were included in the present study. Among these patients, 35 (33%) patients developed hospital-acquired CDI. A total of 35 toxigenic C. difficile strains were assigned to 15 different STs by multi-locus sequence typing (MLST). Multivariate analysis indicated that prolonged hospital stay (OR: 1.045; 95% CI: 1.006 to 1.086) and higher Charlson scores on admission (OR: 3.063; 95% CI: 1.602 to 5.857) were independent factors for the development of CDI among CHB patients without cirrhosis. Conclusions: A high incidence of CDI was detected in this cohort of CHB patients. Both the prolonged hospital stay and higher Charlson scores made CHB patients more susceptible to hospital-acquired CDI. Greater emphasis on infection control measures and antimicrobial stewardship in patients with CHB during hospital admission is needed.

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“…Although the CDT+ strain appeared less frequently in Asia, this was not the first report of this toxin genotype in China. ST5 accounted for 83.7% of binary toxin gene-positive strains in a survey conducted by Chen et al [40] in 2018. Data on C. difficile strains in clade 3 with binary toxins are not well documented in mainland China.…”

Section: Discussionmentioning

confidence: 99%

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

Dai

TianXiang²,

Yan

et al. 2020

BMC Infect Dis

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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.

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Molecular epidemiology and antimicrobial susceptibility of Clostridium difficile isolated from hospitals during a 4-year period in China

Cited by 38 publications

References 41 publications

Clostridioides difficile infection in dogs with chronic-recurring diarrhea responsive to dietary changes

Clostridioides difficile infection in dogs with chronic-recurring diarrhea responsive to dietary changes

Clostridium difficile Infection Among Hospitalized Chronic Hepatitis B Virus-Infected Patients in a Chinese Hospital

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

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