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Molecular epidemiology and antimicrobial susceptibility of Clostridium difficile isolates from two Korean hospitals.
PLoS One. 2017; 12(3):e0174716.Plos

Abstract

Clostridium difficile is one of the main etiological agents causing antibiotic-associated diarrhea. This study investigated the genetic diversity of 70 toxigenic C. difficile isolates from two Korean hospitals by employing toxinotyping, ribotyping, multilocus sequence typing (MLST), and pulsed-field gel electrophoresis (PFGE). Toxin gene amplification resulted in 68 A⁺B⁺ and two A-B+ isolates. Most isolates (95.7-100%) were susceptible to daptomycin, metronidazole, and vancomycin. Seventy C. difficile isolates were classified into five toxinotypes, 19 ribotypes, 16 sequence types (STs), and 33 arbitrary pulsotypes. All C. difficile isolates of ribotype 018 (n = 38) were classified into ST17, which was the most prevalent ST in both hospitals. However, C. difficile isolates of ST17 (ribotype 018) exhibited pulsotypes that differed by hospital. ST2 (ribotype 014/020), 8 (ribotypes 002), 17 (ribotype 018), and 35 (ribotypes 015) were detected in both hospitals, whereas other STs were unique to each hospital. Statistical comparison of the different typing methods revealed that ribotyping and PFGE were highly predictive of STs. In conclusion, our epidemiological study indicates that C. difficile infections in both hospitals are associated with the persistence of endemic clones coupled with the emergence of many unique clones. A combination of MLST with PFGE or ribotyping could be useful for monitoring epidemic C. difficile strains and the emergence of new clones in hospitals.

Authors+Show Affiliations

Department of Microbiology, Kyungpook National University School of Medicine, Daegu, Republic of Korea.Department of Laboratory Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea.Department of Laboratory Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea.Department of Microbiology, Kyungpook National University School of Medicine, Daegu, Republic of Korea.Department of Microbiology, Kyungpook National University School of Medicine, Daegu, Republic of Korea.Department of Microbiology, Kyungpook National University School of Medicine, Daegu, Republic of Korea.Department of Microbiology, Kyungpook National University School of Medicine, Daegu, Republic of Korea.Department of Laboratory Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea.Department of Laboratory Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea.Department of Laboratory Medicine, Inje University College of Medicine, Busan, Republic of Korea.Department of Microbiology, Kyungpook National University School of Medicine, Daegu, Republic of Korea.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

28355266

Citation

Nicholas, Asiimwe, et al. "Molecular Epidemiology and Antimicrobial Susceptibility of Clostridium Difficile Isolates From Two Korean Hospitals." PloS One, vol. 12, no. 3, 2017, pp. e0174716.
Nicholas A, Kim YK, Lee WK, et al. Molecular epidemiology and antimicrobial susceptibility of Clostridium difficile isolates from two Korean hospitals. PLoS One. 2017;12(3):e0174716.
Nicholas, A., Kim, Y. K., Lee, W. K., Selasi, G. N., Na, S. H., Kwon, H. I., Kim, Y. J., Lee, H. S., Song, K. E., Shin, J. H., & Lee, J. C. (2017). Molecular epidemiology and antimicrobial susceptibility of Clostridium difficile isolates from two Korean hospitals. PloS One, 12(3), e0174716. https://doi.org/10.1371/journal.pone.0174716
Nicholas A, et al. Molecular Epidemiology and Antimicrobial Susceptibility of Clostridium Difficile Isolates From Two Korean Hospitals. PLoS One. 2017;12(3):e0174716. PubMed PMID: 28355266.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Molecular epidemiology and antimicrobial susceptibility of Clostridium difficile isolates from two Korean hospitals. AU - Nicholas,Asiimwe, AU - Kim,Yu Kyung, AU - Lee,Won-Kil, AU - Selasi,Gati Noble, AU - Na,Seok Hyeon, AU - Kwon,Hyo Il, AU - Kim,Yoo Jeong, AU - Lee,Hae Sook, AU - Song,Kyung Eun, AU - Shin,Jeong Hwan, AU - Lee,Je Chul, Y1 - 2017/03/29/ PY - 2016/08/26/received PY - 2017/03/14/accepted PY - 2017/3/30/entrez PY - 2017/3/30/pubmed PY - 2017/9/7/medline SP - e0174716 EP - e0174716 JF - PloS one JO - PLoS One VL - 12 IS - 3 N2 - Clostridium difficile is one of the main etiological agents causing antibiotic-associated diarrhea. This study investigated the genetic diversity of 70 toxigenic C. difficile isolates from two Korean hospitals by employing toxinotyping, ribotyping, multilocus sequence typing (MLST), and pulsed-field gel electrophoresis (PFGE). Toxin gene amplification resulted in 68 A⁺B⁺ and two A-B+ isolates. Most isolates (95.7-100%) were susceptible to daptomycin, metronidazole, and vancomycin. Seventy C. difficile isolates were classified into five toxinotypes, 19 ribotypes, 16 sequence types (STs), and 33 arbitrary pulsotypes. All C. difficile isolates of ribotype 018 (n = 38) were classified into ST17, which was the most prevalent ST in both hospitals. However, C. difficile isolates of ST17 (ribotype 018) exhibited pulsotypes that differed by hospital. ST2 (ribotype 014/020), 8 (ribotypes 002), 17 (ribotype 018), and 35 (ribotypes 015) were detected in both hospitals, whereas other STs were unique to each hospital. Statistical comparison of the different typing methods revealed that ribotyping and PFGE were highly predictive of STs. In conclusion, our epidemiological study indicates that C. difficile infections in both hospitals are associated with the persistence of endemic clones coupled with the emergence of many unique clones. A combination of MLST with PFGE or ribotyping could be useful for monitoring epidemic C. difficile strains and the emergence of new clones in hospitals. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/28355266/Molecular_epidemiology_and_antimicrobial_susceptibility_of_Clostridium_difficile_isolates_from_two_Korean_hospitals_ L2 - https://dx.plos.org/10.1371/journal.pone.0174716 DB - PRIME DP - Unbound Medicine ER -