Clostridioides difficile infection (CDI) is the most prevalent healthcare-associated infection in the United States and carries a significant healthcare system burden. As part of an ongoing, active surveillance system of C. difficile throughout Texas, the objective of this study was to assess changes in C. difficile ribotypes of clinical isolates obtained from hospitalized patients in Texas over the past seven years. Fifty hospitals located in Texas, USA sent C. difficile positive stool specimens to a centralized laboratory for PCR ribotyping and toxin characterization between 2011 and 2018. Data collected included specimen collection date, patient age, and sex. Strain genotypes were compiled, and changes in ribotype distribution over time were assessed. Overall, 7796 samples were ribotyped from predominately female patients (58.4%) aged 62 ± 19 years. Samples were obtained from all geographic regions of Texas including Houston/Southwest region (n = 5129; 85%), Dallas/North Texas (n = 579, 9.6%), Central Texas (n = 164; 2.7%), and South Texas (n = 162; 2.6%). The 10 most common ribotypes comprised 73% of all isolates tested during the study period. The most common ribotypes were 027 (17.5%), followed by 014-020 (16.1%), 106 (11.6%), and 002 (9.1%). The prevalence of ribotypes 027, 001, and 078-126 declined significantly over time, while ribotypes 106 and 054 increased in prevalence (P < 0.001). Furthermore, the emergence of a novel ribotype 255 strain was observed. Differences in ribotype distribution were also noted based on age and geographic distribution (P < 0.001, each). This seven-year study demonstrated changing molecular epidemiology of C. difficile in Texas, including the emergence of a novel ribotype 255.

中文翻译：

---

2011 年至 2018 年德克萨斯州艰难梭菌的 PCR 核糖分型，包括核糖分型 255 的出现。

艰难梭菌感染 (CDI) 是美国最常见的医疗保健相关感染，给医疗保健系统带来了巨大的负担。作为整个德克萨斯州持续、积极的艰难梭菌监测系统的一部分，本研究的目的是评估过去七年从德克萨斯州住院患者获得的临床分离株的艰难梭菌核糖型变化。2011年至2018年间，美国德克萨斯州的50家医院将艰难梭菌阳性粪便标本送到中央实验室进行PCR核糖分型和毒素表征。收集的数据包括标本采集日期、患者年龄和性别。编译菌株基因型，并评估核糖型分布随时间的变化。总体而言，对 7796 个样本进行了核糖分型，这些样本主要来自年龄为 62 ± 19 岁的女性患者 (58.4%)。样本取自德克萨斯州所有地理区域，包括休斯顿/西南地区（n = 5129；85%）、达拉斯/北德克萨斯州（n = 579，9.6%）、德克萨斯州中部（n = 164；2.7%）和德克萨斯州南部（n = 162；2.6%）。10 种最常见的核糖核酸型占研究期间测试的所有分离株的 73%。最常见的核糖核酸型是 027 (17.5%)，其次是 014-020 (16.1%)、106 (11.6%) 和 002 (9.1%)。随着时间的推移，核糖体型 027、001 和 078-126 的患病率显着下降，而核糖体型 106 和 054 的患病率则增加 (P < 0.001)。此外，还观察到新型核糖型 255 菌株的出现。还根据年龄和地理分布注意到核糖体分布的差异（每个P<0.001）。这项为期七年的研究证明了德克萨斯州艰难梭菌分子流行病学的变化，包括新型核糖型 255 的出现。