Different molecular characteristics and antimicrobial resistance profiles of Clostridium difficile in the Asia-Pacific region
Year: 2019
Type: article
Study design: Observational Study
Abstract: Molecular epidemiology of Clostridium difficile infection (CDI) has been extensively studied in North America and Europe; however, limited data on CDI are available in the Asia-Pacific region. A multicentre retrospective study was conducted in this region. C. difficile isolates were subjected to multilocus sequence typing (ST) and antimicrobial susceptibility testing. Totally, 394 isolates were collected from Hangzhou, Hong Kong, China; Busan, South Korea; Fukuoka, Japan; Singapore; Perth, Sydney, Australia; New York, the United States. C. difficile isolates included 337 toxin A-positive/B-positive/binary toxin-negative (A+B+CDT-), 48 A-B+CDT-, and nine A+B+CDT+. Distribution of dominant STs varied geographically with ST17 in Fukuoka (18.6%), Busan (56.0%), ST2 in Sydney (20.4%), Perth (25.8%). The antimicrobial resistance patterns were significantly different among the eight sites (χ2 = 325.64, p < 0.001). Five major clonal complexes correlated with unique antimicrobial resistances. Healthcare-associated (HA) CDI was mainly from older patients with more frequent antimicrobial use and higher A-B+ positive rates. Higher resistance to gatifloxacin, tetracycline, and erythromycin were observed in HA-CDI patients (χ2 = 4.76-7.89, p = 0.005-0.029). In conclusion, multiple C. difficile genotypes with varied antimicrobial resistance patterns have been circulating in the Asia-Pacific region. A-B+ isolates from older patients with prior antimicrobial use were correlated with HA-CDI.
Source: Emerging Microbes & Infections
Institutions: UNSW Sydney, Zhejiang Center for Disease Control and Prevention, The University of Sydney, Concord Repatriation General Hospital, Ningbo University, Edith Cowan University, Inje University, Inje University Busan Paik Hospital, Queen Mary Hospital, University of Hong Kong, Fukuoka University, Fukuoka University Hospital, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Affiliated Hangzhou First People's Hospital, Westlake University, School of Medicine, Memorial Sloan Kettering Cancer Center, Cornell University, Weill Cornell Medicine, Murdoch University, Pathwest Laboratory Medicine
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,643
OpenAlex ID: W2982351022