Molecular characterization of Clostridioides difficile isolated from older adults during prospective population-based active surveillance at nine hospitals in Tokyo, Japan, 2018-2020.

IF 2.6 3区 生物学 Q3 MICROBIOLOGY
Zhenghui Li, Ashlesh K Murthy, C Hal Jones, Kwok Lee, Urvi Rajyaguru, Deepika Athinarayanan, Lubomira Andrew, Richard V Goering, Shuhei Ito, Elisa Gonzalez, Pingping Zhang, Paul A Liberator, Warren V Kalina, Michael W Pride, Frederick J Angulo, Jennifer C Moïsi, Kazuhiro Tateda
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引用次数: 0

Abstract

Background: To characterize Clostridioides difficile isolates identified during a prospective multi-hospital population-based study of C. difficile infection (CDI).

Methods: Between December 2018 and March 2020, inpatients ≥50 years of age with new-onset diarrhea in nine Tokyo hospitals were investigated for CDI.. Stool specimens were screened by C. DIFF QUIK CHEK COMPLETE® and glutamate dehydrogenase (GDH) positive stools tested by Xpert® C. difficile/Epi PCR assay. PCR positive stools were tested by cytotoxicity neutralization assay to determine presence of functional toxin. GDH positive stools were also anaerobically cultured and whole genome sequences of C. difficile isolates were acquired.

Results: Toxigenic C. difficile were isolated from 64 patients with CDI; 22 were RT018/356, 9 were RT369, 4 each were RT106 and RT002, 15 were other RTs, and 10 had an unknown RT. Four isolates were positive for binary toxin: one isolate each of RT027, RT078/126, RT080, and one unknown. In terms of the pathogenicity locus profile, 55 were tcdA+/tcdB+ and 9 were tcdA-/tcdB+. In terms of ST, 23 were ST17, nine were ST81, 31 were other STs, and one had a novel ST.

Conclusions: Consistent with prior studies, C. difficile isolates from patients with CDI represented diverse ribotypes with approximately one third of isolates RT018/356. Of note, one isolate each of RT027 and RT078/126 were identified, indicating these hypervirulent strains are present in hospitals in Japan. Public health interventions are needed to reduce the CDI burden in Japan.

2018-2020年日本东京9家医院前瞻性人群主动监测中老年人分离的艰难梭菌分子特征
背景:在一项基于多医院人群的艰难梭菌感染(CDI)前瞻性研究中鉴定出的艰难梭菌分离物。方法:对2018年12月至2020年3月东京9家医院住院≥50岁新发腹泻患者进行CDI调查。采用C. DIFF QUIK CHEK COMPLETE®筛选粪便标本,采用Xpert®艰难梭菌/Epi PCR检测谷氨酸脱氢酶(GDH)阳性粪便标本。采用细胞毒性中和试验检测PCR阳性粪便是否存在功能性毒素。GDH阳性的粪便也进行厌氧培养,并获得艰难梭菌分离株的全基因组序列。结果:64例CDI患者分离到产毒艰难梭菌;RT018/356 22株,RT369 9株,RT106和RT002各4株,其他rt各15株,未知rt 10株。4株双毒阳性,RT027、RT078/126、RT080各1株,未知1株。在致病性位点谱上,tcdA+/tcdB+ 55个,tcdA-/tcdB+ 9个。在ST方面,23例为ST17, 9例为ST81, 31例为其他ST, 1例为新型ST。结论:与先前的研究一致,CDI患者分离的艰难梭菌具有多种核糖型,约三分之一的分离株为RT018/356。值得注意的是,已鉴定出RT027和RT078/126各一株分离株,表明这些高毒力菌株存在于日本的医院中。日本需要采取公共卫生干预措施,以减轻CDI负担。
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来源期刊
Anaerobe
Anaerobe 生物-微生物学
CiteScore
5.20
自引率
8.70%
发文量
137
审稿时长
76 days
期刊介绍: Anaerobe is essential reading for those who wish to remain at the forefront of discoveries relating to life processes of strictly anaerobes. The journal is multi-disciplinary, and provides a unique forum for those investigating anaerobic organisms that cause infections in humans and animals, as well as anaerobes that play roles in microbiomes or environmental processes. Anaerobe publishes reviews, mini reviews, original research articles, notes and case reports. Relevant topics fall into the broad categories of anaerobes in human and animal diseases, anaerobes in the microbiome, anaerobes in the environment, diagnosis of anaerobes in clinical microbiology laboratories, molecular biology, genetics, pathogenesis, toxins and antibiotic susceptibility of anaerobic bacteria.
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