Molecular characterization of Clostridioides difficile isolated from older adults during prospective population-based active surveillance at nine hospitals in Tokyo, Japan, 2018-2020.
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
{"title":"Molecular characterization of Clostridioides difficile isolated from older adults during prospective population-based active surveillance at nine hospitals in Tokyo, Japan, 2018-2020.","authors":"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","doi":"10.1016/j.anaerobe.2025.102985","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>To characterize Clostridioides difficile isolates identified during a prospective multi-hospital population-based study of C. difficile infection (CDI).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":8050,"journal":{"name":"Anaerobe","volume":" ","pages":"102985"},"PeriodicalIF":2.6000,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anaerobe","FirstCategoryId":"99","ListUrlMain":"https://doi.org/10.1016/j.anaerobe.2025.102985","RegionNum":3,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MICROBIOLOGY","Score":null,"Total":0}
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.
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.