In the early 2000s, a binary toxin (CDT)-producing strain of Clostridium difficile, ribotype 027 (RT027), caused extensive outbreaks of diarrheal disease in North America and Europe. This strain has not become established in Australia, and there is a markedly different repertoire of circulating strains there compared to other regions of the world. The C. difficile Antimicrobial Resistance Surveillance (CDARS) study is a nationwide longitudinal surveillance study of C. difficile infection (CDI) in Australia. Here, we describe the molecular epidemiology of CDI in Australian health care and community settings over the first 5 years of the study, 2013 to 2018. Between 2013 and 2018, 10 diagnostic microbiology laboratories from five states in Australia participated in the CDARS study. From each of five states, one private (representing community) and one public (representing hospitals) laboratory submitted isolates of C. difficile or PCR-positive stool samples during two collection periods per year, February-March (summer/autumn) and August-September (winter/spring). C. difficile was characterized by toxin gene profiling and ribotyping. A total of 1,523 isolates of C. difficile were studied. PCR ribotyping yielded 203 different RTs, the most prevalent being RT014/020 (n = 449; 29.5%). The epidemic CDT⁺ RT027 (n = 2) and RT078 (n = 6), and the recently described RT251 (n = 10) and RT244 (n = 6) were not common, while RT126 (n = 17) was the most prevalent CDT⁺ type. A heterogeneous C. difficile population was identified. C. difficile RT014/020 was the most prevalent type found in humans with CDI. Continued surveillance of CDI in Australia remains critical for the detection of emerging strain lineages.

中文翻译：

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2013-2018年，澳大利亚医疗保健和社区环境中基于实验室的艰难梭菌感染监测。

在2000年代初期，在北美和欧洲，一种产二元毒素（CDT）的艰难梭状芽胞杆菌027型（RT027）引起了广泛的腹泻病暴发。这种菌株尚未在澳大利亚建立，与世界其他地区相比，那里的循环菌株种类明显不同。的艰难梭菌抗菌性监测（CDARS）研究是一个全国性的纵向监测研究艰难梭菌澳大利亚感染（CDI）。在这里，我们描述了研究的前5年（2013年至2018年）在澳大利亚医疗保健和社区环境中CDI的分子流行病学。2013年至2018年，来自澳大利亚五个州的10个诊断微生物实验室参与了CDARS研究。在每年的2月至3月（夏季/秋季）和8月-的两个采集期内，来自五个州中的每个州的一个私人（代表社区）和一个公共（代表医院）实验室提交了艰难梭菌或PCR阳性粪便样品的分离株。九月（冬季/春季）。艰难梭菌的特征是毒素基因分析和核糖分型。总计1,523株艰难梭菌被研究了。PCR核糖核酸分型产生了203种不同的RT，其中最普遍的是RT014 / 020（n = 449； 29.5％）。流行CDT ⁺ RT027（n = 2）和RT078（n = 6），以及最近描述的RT251（n = 10）和RT244（n = 6）并不常见，而RT126（n = 17）是最流行的CDT ⁺类型。确定了一个异质艰难梭菌种群。艰难梭状芽胞杆菌RT014 / 020是患有CDI的人类中最常见的类型。在澳大利亚，持续监测CDI对于检测新出现的菌株谱系仍然至关重要。