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Epidemiologic trends in Clostridioides difficile isolate ribotypes in United States from 2011 to 2016.
Anaerobe ( IF 2.3 ) Pub Date : 2020-05-06 , DOI: 10.1016/j.anaerobe.2020.102185
D R Snydman 1 , L A McDermott 1 , S G Jenkins 2 , E J C Goldstein 3 , R Patel 4 , B A Forbes 5 , S Johnson 6 , D N Gerding 6 , C M Thorpe 1 , S T Walk 7
Affiliation  

Background

Geographic and temporal trends in the distribution of PCR ribotypes for Clostridioides difficile associated diarrheal isolates obtained in the United States (US) are changing. As part of a US national surveillance program of C. difficile susceptibility to fidaxomicin, we quantified the distribution of PCR ribotypes of stool isolates collected from 2011 to 2016.

Methods

C. difficile isolates or C. difficile toxin + stools from patients with C. difficile infection (CDI) were submitted for testing to Tufts Medical Center from 6 geographically distinct medical centers. Following isolation and confirmation as C. difficile, approximately 35% of the isolates were randomly sampled, stratified by center, for PCR ribotyping by capillary gel electrophoresis. Toxin gene profiling was performed on all isolates.

Results

939 isolates from a total of 2814 (33.4%) isolated over the 6 years were analyzed. Seventy unique ribotypes were observed, including 19 ribotypes observed 10 or more times. Sixteen ribotypes were not previously observed in our data base. Ribotype 027 declined by more than 60% over the 6 years of the survey from 35.3% to 13.1% (p < 0.001). Ribotype 106 was the most common in 2016, followed by 027 and 014–020. There were strong correlations between 027 and binary toxin with the 18 base pair deletion of tcdC and ribotype 078–126 had 100% concordance with the previously described tcdC 39 base pair deletion.

Conclusions

The frequency of ribotypes in the US has changed with a marked decline in 027. Each of the geographical areas had variations which differed from each other, but collectively, these results suggest that the changing epidemiology of C. difficile in the US is consistent with what is being seen in Europe. Continued surveillance and monitoring of changes in ribotype distributions of C. difficile are warranted.



中文翻译:

2011年至2016年,美国难辨梭状芽孢杆菌的流行病学趋势。

背景

在美国(US)获得的艰难梭状芽胞杆菌相关的腹泻分离株的PCR核型分布的地理和时间趋势正在改变。作为美国艰难梭菌对非达索霉素敏感性美国国家监测计划的一部分,我们量化了2011年至2016年收集的粪便分离株的PCR核糖型分布。

方法

来自艰难梭菌感染(CDI)患者的艰难梭菌分离物或艰难梭菌毒素+粪便已提交给来自6个地理上不同的医疗中心的塔夫茨医疗中心进行测试。分离并确认为艰难梭菌后,随机取样约35%的分离株,中心分层,用于通过毛细管凝胶电泳进行PCR核型分析。对所有分离株进行毒素基因谱分析。

结果

分析了6年中总共分离出的2814份中的939株(33.4%)。观察到七十种独特的核糖型,包括观察到十次或更多次的19种核糖型。在我们的数据库中以前未观察到十六种核糖型。在调查的6年中,027型核糖下降了60%以上,从35.3%下降到13.1%(p <0.001)。核型106是2016年最常见的,其次是027和014-020。027和二元毒素与tcdC的18个碱基对缺失之间有很强的相关性,而核糖体078–126型与先前描述的tcdC 39个碱基对的缺失具有100%的一致性。

结论

在美国,核糖型的发生率发生了变化,并在027年显着下降。每个地理区域的变化都互不相同,但总的来说,这些结果表明,美国艰难梭菌的流行病学变化与在欧洲被看到。继续监测和监测艰难梭菌核糖体分布的变化是必要的。

更新日期:2020-05-06
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