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Investigation of toxin gene diversity, molecular epidemiology, and antimicrobial resistance of Clostridium difficile isolated from 12 hospitals in South Korea

Authors
 Heejung Kim  ;  Seok Hoon Jeong  ;  Kyoung Ho Roh  ;  Seong Geun Hong  ;  Jong Wan Kim  ;  Myung-Geun Shin  ;  Mi-Na Kim  ;  Hee Bong Shin  ;  Young Uh  ;  Hyukmin Lee  ;  Kyungwon Lee 
Citation
 KOREAN JOURNAL OF LABORATORY MEDICINE , Vol.30(5) : 491-497, 2010 
Journal Title
 KOREAN JOURNAL OF LABORATORY MEDICINE 
ISSN
 1598-6535 
Issue Date
2010
MeSH
Clostridium Infections/microbiology ; Clostridium difficile/classification ; Clostridium difficile/genetics* ; Clostridium difficile/isolation & purification ; Diarrhea/microbiology ; Drug Resistance, Bacterial* ; Enterotoxins/genetics* ; Genetic Variation ; Genotype ; Hospitals, University ; Humans ; Microbial Sensitivity Tests ; Republic of Korea ; Ribotyping
Keywords
Clostridium difficile ; toxin A ; toxin B ; Ribotyping ; Drug Resistance ; Epidemiology
Abstract
BACKGROUND: Clostridium difficile is a major cause of antibiotic-associated diarrhea. The objective of this study was to characterize clinical isolates of C. difficile obtained from various regions in Korea with regard to their toxin status, molecular type, and antimicrobial susceptibility. METHODS: We analyzed a total of 408 C. difficile isolates obtained between 2006 and 2008 from 408 patients with diarrhea in 12 South Korean teaching hospitals. C. difficile toxin genes tcdA, tcdB, cdtA, and cdtB were detected by PCR. Molecular genotyping was performed by PCR ribotyping. Antimicrobial susceptibilities of the 120 C. difficile isolates were assessed by agar dilution methods. RESULTS: Among 337 toxigenic isolates, 105 were toxin A-negative and toxin B-positive (A(-)B(+)) and 29 were binary toxin-producing strains. PCR ribotyping showed 50 different ribotype patterns. The 5 most frequently occurring ribotypes comprised 62.0% of all identified ribotypes. No isolate was susceptible to cefoxitin, and all except 1 were susceptible to piperacillin and piperacillin-tazobactam. The resistance rates of isolates to imipenem, cefotetan, moxifloxacin, ampicillin, and clindamycin were 25%, 34%, 42%, 51%, and 60%, respectively. The isolates showed no resistance to metronidazole or vancomycin. CONCLUSIONS: This is the first nationwide study on the toxin status, including PCR ribotyping and antimicrobial resistance, of C. difficile isolates in Korea. The prevalence of A-B+ strains was 25.7%, much higher than that reported from other countries. Binary toxin-producing strains accounted for 7.1% of all strains, which was not rare in Korea. The most prevalent ribotype was ribotype 017, and all A-B+ strains showed this pattern. We did not isolate strains with decreased susceptibility to metronidazole or vancomycin.
Files in This Item:
T201002827.pdf Download
DOI
10.3343/kjlm.2010.30.5.491
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Heejung(김희정) ORCID logo https://orcid.org/0000-0002-0190-703X
Lee, Kyungwon(이경원) ORCID logo https://orcid.org/0000-0003-3788-2134
Jeong, Seok Hoon(정석훈) ORCID logo https://orcid.org/0000-0001-9290-897X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/101771
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