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KMID : 1120220170080050325
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Osong Public Health and Research Perspectives
2017 Volume.8 No. 5 p.325 ~ p.331
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Characterization of Clostridium difficile Strains Isolated from Patients with C. difficile-associated Disease in Korea
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Cho Seung-Hak
Chon Jung-Whan
Seo Kun-Ho
Kim Young-Kwon
Kim Jung-Beom
Bak Young-Seok
Jung Woon-Won
Kim Cheorl-Ho
Choi Jong-Tae
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Abstract
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Objectives: Studies on Clostridium difficile are rare in Korea. We investigated the epidemiological characteristics of C. difficile isolates from patients with C. difficile-associated disease (CDAD) in Korea.
Methods: Multiplex polymerase chain reaction was performed to detect the presence of tcdA and tcdB toxin genes. Antimicrobial susceptibility test was carried out by the disk-dilution method. C. difficile strains were subtyped by automated repetitive-element palindromic PCR (rep-PCR).
Results: Among patients with CDAD, 73 (25.8%), 32 (11.3%), 32 (11.3%), and 26 (9.2%) suffered from pneumonia, cancer or neoplasm, diabetes, and colitis, respectively. Of all stool samples, 43 samples (15.2%) were positive for C. difficile strains. We observed two expression patterns of toxin genes: tcdA+/tcdB+ (86% isolates) and tcdA?/tcdB+ (14% isolates), with all isolates expressing tcdB. Furthermore, some isolates were resistant to clindamycin (65%), ampicillin (56%), and cefazolin (40%), but all were susceptible to vancomycin and metronidazole. The tested samples were classified into diverse clusters using automated rep-PCR.
Conclusion: Our findings revealed the characteristics and antibiotic resistance of C. difficile isolates from patients in Korea. The epidemiological data may provide valuable insight into development of treatment strategies for C. difficile infections in Korea.
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KEYWORD
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Clostridium difficile, epidemiological characterization
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