"An epidemiological surveillance study (2021-2022): detection of a high diversity of <i>Clostridioides difficile</i> isolates in one tertiary hospital in Chongqing, Southwest China"

作者全名："Cui, Yihong; Zhang, Chuanming; Jia, Qianying; Gong, Xue; Tan, Yu; Hua, Xinping; Jian, Wenwen; Yang, Shenglin; Hayer, Kim; Idris, Raja Kamarudin Raja; Zhang, Yi; Wu, Yuan; Tu, Zeng"

作者地址："[Cui, Yihong; Gong, Xue; Tan, Yu; Hua, Xinping; Jian, Wenwen; Yang, Shenglin; Tu, Zeng] Chongqing Med Univ, Coll Basic Med Sci, Dept Pathogen Biol, Chongqing 400016, Peoples R China; [Zhang, Chuanming] Chongqing Med Univ, Affiliated Hosp 1, Dept Lab Med, Chongqing 400016, Peoples R China; [Jia, Qianying] Chongqing Med Univ, Dept Infect Dis, Affiliated Hosp 1, Chongqing 400016, Peoples R China; [Hayer, Kim; Idris, Raja Kamarudin Raja] Univ Leicester, Leicester Med Sch, Leicester LE1 7RH, England; [Zhang, Yi] Chongqing Med Univ, Int Med Coll, Chongqing 400016, Peoples R China; [Wu, Yuan] Chinese Ctr Dis Control & Prevent, State Key Lab Infect Dis Prevent & Control, Natl Inst Communicable Dis Control & Prevent, Beijing 102206, Peoples R China"

通信作者："Tu, Z (通讯作者)，Chongqing Med Univ, Coll Basic Med Sci, Dept Pathogen Biol, Chongqing 400016, Peoples R China."

来源：BMC INFECTIOUS DISEASES

ESI学科分类：IMMUNOLOGY

WOS号：WOS:001099357500002

JCR分区：Q2

影响因子：3.4

年份：2023

卷号：23

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：C. difficile; Molecular epidemiology; Risk factors; Antibiotics resistance

摘要："Background Clostridioides difficile is a bacterium that causes antibiotic-associated infectious diarrhea and pseudomembranous enterocolitis. The impact of C. difficile infection (CDI) in China has gained significant attention in recent years. However, little epidemiological data are available from Chongqing, a city located in Southwest China. This study aimed to investigate the epidemiological pattern of CDI and explore the drug resistance of C. difficile isolates in Chongqing.Methods A case-control study was conducted to investigate the clinical infection characteristics and susceptibility factors of C. difficile. The features of the C. difficile isolates were evaluated by testing for toxin genes and using multi-locus sequence typing (MLST). The susceptibility of strains to nine antibiotics was determined using agar dilution technique.Results Out of 2084 diarrhea patients, 90 were tested positive for the isolation of toxigenic C. difficile strains, resulting in a CDI prevalence rate of 4.32%. Tetracycline, cephalosporins, hepatobiliary disease, and gastrointestinal disorders were identified as independent risk factors for CDI incidence. The 90 strains were classified into 21 sequence types (ST), with ST3 being the most frequent (n = 25, 27.78%), followed by ST2 (n = 10, 11.11%) and ST37 (n = 9, 10%). Three different toxin types were identified: 69 (76.67%) were A+B+CDT-, 12 (13.33%) were A-B+CDT-, and 9 (10%) were A+B+CDT+. Although substantial resistance to erythromycin (73.33%), moxifloxacin (62.22%), and clindamycin (82.22%), none of the isolates exhibited resistance to vancomycin, tigecycline, or metronidazole. Furthermore, different toxin types displayed varying anti-microbial characteristics.Conclusions The strains identified in Chongqing, Southwest China, exhibited high genetic diversity. Enhance full awareness of high-risk patients with HA-CDI infection, particularly those with gastrointestinal and hepatocellular diseases, and emphasize caution in the use of tetracycline and capecitabine. These findings suggest that a potential epidemic of CDI may occur in the future, emphasizing the need for timely monitoring."

基金机构：Not applicable.

基金资助正文：Not applicable.