The global epidemic of nosocomial diarrhea caused by Clostridioides (Clostridium) difficile started in 2000, with high mortality rates and emergence of a new hypervirulent strain NAP1/BI/027. The aim of this study was to assess the presence of ribotype 027 and other C. difficile ribotypes in a Serbian University Hospital, compare the temporal variability of ribotypes 3 years apart, as well as to compare clinical, demographic and laboratory characteristics and disease outcome among patients infected with 027 and non-027 ribotype. This was a prospective observational cohort study addressing 4-month intervals during 2014/2015 and 2017/2018. Ribotyping was performed in 64 non-duplicate C. difficile strains. Ribotype 027 was the most prevalent, and was detected in 53 (82.8%) patients (43/45 and 10/19 patients in 2014–2015 and 2017/2018, respectively). Other detected ribotypes were 001/072 in 4 (6.3%), 002 in 4 (6.3%), 014/020 in 2 (3.1%) and 176 in 1 (1.5%) patient. The percentage of the patients infected with ribotype 027 significantly decreased during the 3-year period, from 95.6 to 52.6% (p < 0.001). Ribotype 027 infection was associated with fluoroquinolone treatment more frequently than infection with other ribotypes [33 (62.3%) vs. 2 (18.2%), p = 0.010)]. A severe C. difficile infection was diagnosed more often in patients with the detected ribotype 027 compared to those infected with non-027 ribotypes (p = 0.006). No significant difference in the mortality and recurrence rates was found between the patients infected with ribotype 027 and those infected with other ribotypes [10/53 (18.8%) vs. 2/11 (18.2%), p = 0.708, and 10/35 (28.6%) vs. 0/2 (0%), p = 1.000, respectively]. Clostridium difficile ribotype 027 was the most prevalent ribotype among patients in a large Serbian hospital, but there is a clear decreasing trend.

中文翻译：

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塞尔维亚一家大型教学医院的艰难梭菌核糖型分布。

由艰难梭菌（Clostridium difficile）引起的全球医院腹泻流行始于 2000 年，死亡率很高，并出现了一种新的高毒力菌株 NAP1/BI/027。本研究的目的是评估塞尔维亚大学医院中 027 型核糖体和其他艰难梭菌核糖体的存在情况，比较核糖体相隔 3 年的时间变异性，以及比较临床、人口统计学和实验室特征以及疾病结果感染 027 和非 027 核糖型的患者。这是一项前瞻性观察性队列研究，涉及 2014/2015 年和 2017/2018 年期间的 4 个月间隔。在 64 个非重复的艰难梭菌菌株中进行核糖分型。核糖型 027 最为普遍，在 53 名 (82.8%) 患者中检测到（2014-2015 年和 2017/2018 年分别为 43/45 和 10/19 名患者）。其他检测到的核糖型为 4 名 (6.3%) 中的 001/072、4 名 (6.3%) 中的 002、2 名 (3.1%) 中的 014/020 和 1 名 (1.5%) 患者中的 176。在 3 年期间，感染核糖型 027 的患者比例显着下降，从 95.6% 降至 52.6% (p < 0.001)。与其他核糖型感染相比，027 型核糖体感染与氟喹诺酮类药物治疗相关的频率更高 [33 (62.3%) 对 2 (18.2%)，p = 0.010)]。与感染非 027 核糖型的患者相比，检测到 027 核糖型的患者更常诊断出严重的艰难梭菌感染（p = 0.006）。感染 027 核糖型的患者与感染其他核糖型的患者的死亡率和复发率没有显着差异 [10/53 (18.8%) 对 2/11 (18.2%)，p = 0.708 和 10/35 (28.6%) 与 0/2 (0%)，p = 1.000，分别]。