title: Clinical use comparison of a semiautomated PCR with fluorescent ribotyping for typing of Clostridium difficile.
abstract: Molecular typing of Clostridium difficile is performed to assess strain relatedness or place strains within an epidemiological context. Different C. difficile ribotyping systems are available. However, a common strain library does not exist. We aimed to compare ribotyping results of 29 clinical C. difficile isolates by two methods: semiautomated PCR-ribotyping and fluorescent PCR-ribotyping. For certain ribotypes (n = 16/29; 55.2 %), the inter-laboratory reproducibility was consistent among multiple samples from individual subjects, while 54.8 % (n = 14/29) were discordant. Additionally, 11/29 ribotypes (38 %) and 12/29 ribotypes (41 %) did not match with known reference strains in the semiautomated PCR-fluorescent ribotyping systems' libraries, respectively. The identification of 027 ribotype by both systems was consistent for 75 % of the isolates. Discriminatory indices for the semiautomated PCR-ribotyping and fluorescent PCR-ribotyping systems are 0.906 and 0.886, respectively. Although ribotyping provides important epidemiologic insights, the lack of a common strain library makes interpretation of results using different ribotyping protocols difficult.
authors.affiliation: Center for Anti-infective Research and Development, Hartford Hospital, 80 Seymour Street, Hartford, CT, 06102, USA.|Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Abrar K
authors.initials: AK
authors.lastname: Thabit
authors.affiliation: University of Houston College of Pharmacy, Houston, TX, USA.
authors.forename: M Jahangir
authors.initials: MJ
authors.lastname: Alam
authors.affiliation: Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
authors.forename: Carey-Ann D
authors.initials: CD
authors.lastname: Burnham
authors.affiliation: Center for Anti-infective Research and Development, Hartford Hospital, 80 Seymour Street, Hartford, CT, 06102, USA. david.nicolau@hhchealth.org.|Division of Infectious Diseases, Hartford Hospital, Hartford, CT, USA. david.nicolau@hhchealth.org.
authors.forename: David P
authors.initials: DP
authors.lastname: Nicolau
mesh_terms: D016360:Clostridioides difficile / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D005453:Fluorescence; D006801:Humans; D016133:Polymerase Chain Reaction / Q000379:methods*; D015203:Reproducibility of Results; D021521:Ribotyping / Q000379:methods*
keywords: Clostridium difficile; Fluorescent PCR; PCR; Ribotype