title: [Relationship between Clostridium difficile ITS-PCR Type and Pathogenicity].
abstract: Clostridium difficile (C. difficile) causes antibiotic-associated diarrhea and nosocomial infection. The PCR of internal transcribed spacer regions (ITS) is easily conductible in a relatively short time. The purpose of the current study is to classify C. difficile by PCR electrophoresis pattern of ITS (ITS-PCR type) and estimate the relationship of the ITS-PCR type of C. difficile with its pathogenicity. We examined 77 strains which were obtained in our hospital from March 2012 to August 2013. Toxin genes were detected by PCR using toxin gene specific primers. Antimicrobial sensitivities were measured by E-test. Pseudomembrane formation and severity of the illness in clinical patients were investigated based on the medical records. The strains were classified into the 33 ITS-PCR types. Among them, most of strains in 18 PCR types were not associated with any toxin genes. Strains with toxin A(+)/B(+)genes were classified into 14PCR types. The 3 strains with toxin B (+) strains and the two strains with toxin A(+)/B(+)/binary toxin(+) genes were classified into 1 PCR type, type 17, and type 16, respectively. 6 strains in 13 strains of type 33, and 5 strains in 11 strains of type 2 were detected from the same ward, presuming nosocomial infection. Minimum inhibitory concentrations (MICs) of vancomycin and metronidazole were ≤ 2 μg/mL, distribution of MICs were not correlated with ITS-PCR type. The pseudomembrane forming and severity of the illness were not obviously related to ITS-PCR pattern. Thus, the typing of C. difficile by ITS-PCR pattern is considered to be useful for early detection of nosocomial infection, and assessment of toxigenicity.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Takemori
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Senda
authors.forename: Tomoko
authors.initials: T
authors.lastname: Munesue
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Horita
authors.forename: Mikio
authors.initials: M
authors.lastname: Nagahara
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Iwata
authors.forename: Taizo
authors.initials: T
authors.lastname: Wada
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Sakai
authors.forename: Takashi
authors.initials: T
authors.lastname: Wada
mesh_terms: D002462:Cell Membrane; D016360:Clostridioides difficile / Q000235:genetics*; D024881:Drug Resistance, Bacterial; D004761:Enterocolitis, Pseudomembranous / Q000382:microbiology / Q000503:physiopathology; D006801:Humans; D016133:Polymerase Chain Reaction; D012720:Severity of Illness Index