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Emergence of Clostridium difficile ribotype 027 in Korea.
Korean J Lab Med. 2011 Jul; 31(3):191-6.KJ

Abstract

BACKGROUND

Clostridium difficile infection (CDI) has markedly risen and is associated with hypervirulent ribotype 027 outbreaks in North America and Europe since 2003. The aims of this study were to determine the prevalence of ribotype 027 among C. difficile isolates in Korea, to characterize the ribotype 027 isolates, and to determine the clinical severity of CDI in patients infected with these isolates.

METHODS

A total of 1,251 isolates of C. difficile recovered from stool specimens of suspected CDI patients at two tertiary-care hospitals and one commercial laboratory between 2002 and 2009. Genes for toxin A (tcdA), toxin B (tcdB), and binary toxin (cdtA and cdtB) were detected by PCR. Mutation in the tcdC gene was detected by sequencing after PCR amplification. For molecular genotyping, we performed PCR-ribotyping, pulsed-field gel electrophoresis (PFGE), and multilocus variable-number tandem-repeat analysis (MLVA). Minimum inhibitory concentrations of moxifloxacin were determined using Etest strips (AB bioMérieux, Sweden).

RESULTS

We identified 7 isolates as ribotype 027. These isolates had the same tcdC mutation as the epidemic strain, and 6 of them were resistant to moxifloxacin. The isolates were categorized into 3 different PFGE types and 7 different MLVA types. All the 7 cases had occurred sporadically.

CONCLUSIONS

C. difficile ribotype 027 is uncommon, but it has emerged in Korea. The spread of this ribotype should be closely monitored in order to avoid an outbreak of CDI in Korea.

Authors+Show Affiliations

Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21779194

Citation

Kim, Heejung, et al. "Emergence of Clostridium Difficile Ribotype 027 in Korea." The Korean Journal of Laboratory Medicine, vol. 31, no. 3, 2011, pp. 191-6.
Kim H, Lee Y, Moon HW, et al. Emergence of Clostridium difficile ribotype 027 in Korea. Korean J Lab Med. 2011;31(3):191-6.
Kim, H., Lee, Y., Moon, H. W., Lim, C. S., Lee, K., & Chong, Y. (2011). Emergence of Clostridium difficile ribotype 027 in Korea. The Korean Journal of Laboratory Medicine, 31(3), 191-6. https://doi.org/10.3343/kjlm.2011.31.3.191
Kim H, et al. Emergence of Clostridium Difficile Ribotype 027 in Korea. Korean J Lab Med. 2011;31(3):191-6. PubMed PMID: 21779194.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Emergence of Clostridium difficile ribotype 027 in Korea. AU - Kim,Heejung, AU - Lee,Yangsoon, AU - Moon,Hee-Won, AU - Lim,Chae Seung, AU - Lee,Kyungwon, AU - Chong,Yunsop, Y1 - 2011/06/28/ PY - 2011/01/14/received PY - 2011/04/18/revised PY - 2011/04/19/accepted PY - 2011/7/23/entrez PY - 2011/7/23/pubmed PY - 2011/12/13/medline KW - Clostridium difficile KW - Multilocus variable-number tandem-repeat analysis KW - PCR-ribotype 027 KW - Pulsed-field gel electrophoresis SP - 191 EP - 6 JF - The Korean journal of laboratory medicine JO - Korean J Lab Med VL - 31 IS - 3 N2 - BACKGROUND: Clostridium difficile infection (CDI) has markedly risen and is associated with hypervirulent ribotype 027 outbreaks in North America and Europe since 2003. The aims of this study were to determine the prevalence of ribotype 027 among C. difficile isolates in Korea, to characterize the ribotype 027 isolates, and to determine the clinical severity of CDI in patients infected with these isolates. METHODS: A total of 1,251 isolates of C. difficile recovered from stool specimens of suspected CDI patients at two tertiary-care hospitals and one commercial laboratory between 2002 and 2009. Genes for toxin A (tcdA), toxin B (tcdB), and binary toxin (cdtA and cdtB) were detected by PCR. Mutation in the tcdC gene was detected by sequencing after PCR amplification. For molecular genotyping, we performed PCR-ribotyping, pulsed-field gel electrophoresis (PFGE), and multilocus variable-number tandem-repeat analysis (MLVA). Minimum inhibitory concentrations of moxifloxacin were determined using Etest strips (AB bioMérieux, Sweden). RESULTS: We identified 7 isolates as ribotype 027. These isolates had the same tcdC mutation as the epidemic strain, and 6 of them were resistant to moxifloxacin. The isolates were categorized into 3 different PFGE types and 7 different MLVA types. All the 7 cases had occurred sporadically. CONCLUSIONS: C. difficile ribotype 027 is uncommon, but it has emerged in Korea. The spread of this ribotype should be closely monitored in order to avoid an outbreak of CDI in Korea. SN - 1598-6535 UR - https://www.unboundmedicine.com/medline/citation/21779194/Emergence_of_Clostridium_difficile_ribotype_027_in_Korea_ L2 - http://www.annlabmed.org/journal/viewJournal.html?year=2011&vol=31&page=191 DB - PRIME DP - Unbound Medicine ER -