Antimicrobial susceptibilities and molecular epidemiology of clinical isolates of Clostridium difficile in taiwan.
The antimicrobial susceptibility and virulence factors of Clostridium difficile clinical isolates in Taiwan have not previously been reported. One hundred and thirteen isolates were collected from two major teaching hospitals in Taiwan from 2001 to 2009. Molecular typing was performed by an automated repetitive extragenic palindromic sequence-based PCR (rep-PCR) method (DiversiLab; Bacterial Barcodes, Inc., Athens, GA) and PCR ribotyping. Detection of tcdA, tcdB, cdtA, and cdtB genes was performed using a multiplex PCR assay, and gyrA and gyrB genes of moxifloxacin-nonsusceptible isolates were sequenced. All isolates were susceptible to vancomycin and metronidazole. Ninety-five (84%) isolates were susceptible to moxifloxacin, and the MIC(90) for nemonoxacin was 4 μg/ml. Tigecycline showed favorable antibacterial activity (MIC(90) of 0.06 μg/ml). Thirteen rep-PCR types were identified as a predominant rep-PCR type (type A; non-North American pulsed-field gel electrophoresis type 1 [NAP1], -NAP7, or -NAP8) accounting for 52.2% (59 isolates). Nine of 18 moxifloxacin-nonsusceptible isolates belonged to the rep-PCR type A. The rep-PCR type A and C isolates were distinct from NAP1 (ribotype 027) and NAP8 (ribotype 078) as determined by PCR ribotyping. Seventy-four (65%) isolates harbored tcdA and tcdB, and 15 (13%) harbored cdtAB encoding binary toxin. Eleven isolates had a gene deletion in tcdC, including a 39-bp deletion (9 isolates) and an 18-bp deletion (2). In conclusion, dissemination of a predominant C. difficile clone in southern and northern Taiwan was noted. However, no NAP1 (ribotype 027) isolate could be discovered in this study.
Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
Yi-Chun
YC
Lin
Yu-Tsung
YT
Huang
Pei-Jane
PJ
Tsai
Tai-Fen
TF
Lee
Nan-Yao
NY
Lee
Chun-Hsing
CH
Liao
Shyr-Yi
SY
Lin
Wen-Chien
WC
Ko
Po-Ren
PR
Hsueh
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001372:Aza Compounds / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics; D016360:Clostridioides difficile / Q000145:classification / Q000187:drug effects* / Q000235:genetics*; D024841:Fluoroquinolones; D005838:Genotype; D008795:Metronidazole / Q000494:pharmacology; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology / Q000379:methods*; D000077266:Moxifloxacin; D016133:Polymerase Chain Reaction; D011804:Quinolines / Q000494:pharmacology; D021521:Ribotyping; D013624:Taiwan; D014640:Vancomycin / Q000494:pharmacology
D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D001426:Bacterial Proteins; D024841:Fluoroquinolones; D011804:Quinolines; D008795:Metronidazole; D014640:Vancomycin; D000077266:Moxifloxacin
Emerg Infect Dis. 2010 Aug;16(8):1204-10
20678312
Clin Infect Dis. 2008 Nov 1;47(9):1162-70
18808358
Antimicrob Agents Chemother. 2002 Nov;46(11):3418-21
12384345
Antimicrob Agents Chemother. 2006 Oct;50(10):3375-80
17005820
Clin Microbiol Infect. 2011 Feb;17(2):166-75
20331683
J Antimicrob Chemother. 2006 Nov;58(5):1062-5
17030519
N Engl J Med. 2005 Dec 8;353(23):2442-9
16322602
Diagn Microbiol Infect Dis. 2000 Sep;38(1):51-8
11025184
Lancet. 2005 Sep 24-30;366(9491):1079-84
16182895
Am J Gastroenterol. 2007 Dec;102(12):2781-8
17900327
Clin Microbiol Infect. 2008 Nov;14(11):1057-64
19040478
J Clin Microbiol. 2002 Jan;40(1):101-4
11773100
J Clin Microbiol. 1999 Feb;37(2):461-3
9889244
Ann Intern Med. 1998 Jun 15;128(12 Pt 1):989-95
9625685
Clin Infect Dis. 2009 Jun 15;48(12):1732-5
19435431
Int J Antimicrob Agents. 2010 Mar;35(3):311-2
20045292
Antimicrob Agents Chemother. 2010 Mar;54(3):1338-42
20065058
J Antimicrob Chemother. 2006 Dec;58(6):1264-7
17018563
Ann Intern Med. 1994 Feb 15;120(4):272-7
8080497
N Engl J Med. 2008 Oct 30;359(18):1932-40
18971494
J Med Microbiol. 2008 Jun;57(Pt 6):784-789
18480338
J Microbiol Immunol Infect. 2006 Jun;39(3):242-8
16783456
Clin Infect Dis. 2005 Nov 1;41(9):1254-60
16206099
Lancet Infect Dis. 2010 Jun;10(6):395-404
20510280
N Engl J Med. 2005 Dec 8;353(23):2433-41
16322603
Clin Microbiol Infect. 2010 Aug;16(8):1104-10
19732094
Gut. 1986 Oct;27(10):1169-72
3781329
Clin Infect Dis. 2008 Jan 15;46 Suppl 1:S19-31
18177218
Gastroenterology. 2009 May;136(6):1913-24
19457419
Antimicrob Agents Chemother. 2007 Aug;51(8):2716-9
17517836
J Microbiol Immunol Infect. 2010 Apr;43(2):119-25
20457428