Rapid analysis of Clostridium difficile strains recovered from hospitalized patients by using the slpA sequence typing system.
Clostridium difficile is a nosocomial pathogen that is transmissible between patients via hospital staff and via contaminated environmental surfaces. Recently, a typing system based on the slpA sequence for C. difficile was developed. To elucidate the validity and efficacy of the system in the setting of a local hospital, we carried out typing of C. difficile from patients in our hospital using the system. Twenty-eight stool samples obtained from 17 patients with C. difficile-associated diarrhea were investigated. Twenty-two of the 28 samples were positive for C. difficile by stool culture, and they were able to be classified by slpA sequence typing. The smz-1 and smz-2 strains were revealed to be the predominant types in our hospital, accounting for 73% of all strains. The yok-1, yok-2, t25-1, hr-1, and hj2-2 strains were identified in 1 patient each. The smz-1 strain was identified in all wards except for ward D, while smz-2 was identified in 3 of 4 patients in ward D and was restricted to this ward. Nosocomial infection of smz-1 and smz-2 in our hospital was demonstrated. Distinguishing smz-1 from smz-2 by slpA sequence typing clarified the transmission of C. difficile among patients. In conclusion, slpA sequence typing was useful in the setting of a local hospital and may be a powerful tool for the epidemiological study of C. difficile infection.
Kato
Hideaki
H
Department of Gastroenterology, Toyokawa City Hospital, Kohmeicho 1-19, Toyokawa, 442-8561, Japan. hideakik@k6.dion.ne.jp
Kato
Haru
H
Nakamura
Makoto
M
Iwashima
Yasuhito
Y
Nakamura
Atsushi
A
Ueda
Ryuzo
R
D000368:Aged; D001425:Bacterial Outer Membrane Proteins / Q000235:genetics; D001426:Bacterial Proteins / Q000235:genetics*; D015373:Bacterial Typing Techniques / Q000379:methods*; D016360:Clostridioides difficile / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000175:diagnosis* / Q000382:microbiology; D003428:Cross Infection / Q000175:diagnosis* / Q000382:microbiology; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000175:diagnosis* / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D017422:Sequence Analysis, DNA
D001425:Bacterial Outer Membrane Proteins; D001426:Bacterial Proteins; C070683:surface layer protein A, Bacteria