title: Molecular Epidemiology and Antimicrobial Susceptibility ofClostridium difficileIsolates from a University Teaching Hospital in China.
abstract: While the developed world has seen a significant increase in the number of scientific articles onClostridium difficileinfection (CDI), the developing world still lags behind on this subject due to limited laboratory capacity, low awareness, and limited surveillance of this problem. As such, CDI is considered a neglected but potentially huge problem in developing countries. The major aim of this study was to systemically evaluate the utility of several molecular typing tools for CDI, including their relevance in epidemiological studies in developing countries such as China. A total of 116 non-repetitive toxigenicC. difficileisolates from Chinese patients, were studied. The isolates comprised 83 (71.6%) A+B+CDT- isolates, 27 (23.3%) A-B+CDT- isolates, and 6 (5.1%) A+B+CDT+ isolates. Typing methods evaluated included multilocus variable-number tandem-repeat analysis, PCR ribotyping, multilocus sequence typing, and sequencing ofslpAandtcdCgenes, which identified 113, 30, 22, 18, and 8 genotypes each and exhibited discriminatory powers of 0.999, 0.916, 0.907, 0.883, and 0.765, respectively. Compared to A+B+ strains, A-B+ strains exhibited higher prevalence of drug resistance to clindamycin, erythromycin, levofloxacin, rifampicin, rifaximin, and tetracycline. Furthermore, drug resistance rates of strains with different PCR ribotypes differed, supporting the importance of molecular typing in management and control of CDI. Based on our earlier suggestion to improve the diagnostic laboratory capacity of CDI in developing countries, setting up efficient surveillance programs complemented by relevant molecular typing methods is warranted.
authors: Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesBeijing, China; Graduate School, Peking Union Medical College, Chinese Academy of Medical SciencesBeijing, China.
authors: Jing-Wei
authors: JW
authors: Cheng
authors: Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences Beijing, China.
authors: Meng
authors: M
authors: Xiao
authors: School of Biomedical Sciences, Charles Sturt UniversityOrange, NSW, Australia; Centre for Infectious Diseases and Microbiology Laboratory Services, Westmead HospitalSydney, NSW, Australia.
authors: Timothy
authors: T
authors: Kudinha
authors: School of Biomedical Sciences, Charles Sturt University Orange, NSW, Australia.
authors: Fanrong
authors: F
authors: Kong
authors: Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences Beijing, China.
authors: Zhi-Peng
authors: ZP
authors: Xu
authors: Teaching and Research Section of Clinical Laboratory, School of Public Health, Taishan Medical School Taian, China.
authors: Lin-Ying
authors: LY
authors: Sun
authors: Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences Beijing, China.
authors: Li
authors: L
authors: Zhang
authors: Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesBeijing, China; Graduate School, Peking Union Medical College, Chinese Academy of Medical SciencesBeijing, China.
authors: Xin
authors: X
authors: Fan
authors: Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences Beijing, China.
authors: Xiu-Li
authors: XL
authors: Xie
authors: Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences Beijing, China.
authors: Ying-Chun
authors: YC
authors: Xu
keywords: China; Clostridium difficile; antimicrobial resistance; molecular typing; surveillance