Open AccessAntimicrobial Susceptibilities and Molecular Epidemiology of Clinical Isolates of Clostridium difficile in Taiwan
Author(s) -
Yi Chun Lin,
Yu-Tsung Huang,
Pei Jane Tsai,
Tai Fen Lee,
Nan Yao Lee,
Chun-Hsing Liao,
Shyr Yi Lin,
Wen Chien Ko,
PoRen Hsueh
Publication year - 2011
Publication title -
antimicrobial agents and chemotherapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.07
H-Index - 259
eISSN - 1070-6283
pISSN - 0066-4804
DOI - 10.1128/aac.01440-10
Subject(s) - ribotyping , clostridium difficile , microbiology and biotechnology , biology , moxifloxacin , multilocus sequence typing , molecular epidemiology , pseudomembranous colitis , typing , virology , multiplex polymerase chain reaction , polymerase chain reaction , genotype , gene , antibiotics , genetics
The antimicrobial susceptibility and virulence factors ofClostridium difficile clinical isolates in Taiwan have not previously been reported. One hundred and thirteen isolates were collected from two major teaching hospitals in Taiwan from 2001 to 2009. Molecular typing was performed by an automated repetitive extragenic palindromic sequence-based PCR (rep-PCR) method (DiversiLab; Bacterial Barcodes, Inc., Athens, GA) and PCR ribotyping. Detection oftcdA ,tcdB ,cdtA , andcdtB genes was performed using a multiplex PCR assay, andgyrA andgyrB genes of moxifloxacin-nonsusceptible isolates were sequenced. All isolates were susceptible to vancomycin and metronidazole. Ninety-five (84%) isolates were susceptible to moxifloxacin, and the MIC90 for nemonoxacin was 4 μg/ml. Tigecycline showed favorable antibacterial activity (MIC90 of 0.06 μg/ml). Thirteen rep-PCR types were identified as a predominant rep-PCR type (type A; non-North American pulsed-field gel electrophoresis type 1 [NAP1], -NAP7, or -NAP8) accounting for 52.2% (59 isolates). Nine of 18 moxifloxacin-nonsusceptible isolates belonged to the rep-PCR type A. The rep-PCR type A and C isolates were distinct from NAP1 (ribotype 027) and NAP8 (ribotype 078) as determined by PCR ribotyping. Seventy-four (65%) isolates harboredtcdA andtcdB , and 15 (13%) harboredcdtAB encoding binary toxin. Eleven isolates had a gene deletion intcdC , including a 39-bp deletion (9 isolates) and an 18-bp deletion (2). In conclusion, dissemination of a predominantC. difficile clone in southern and northern Taiwan was noted. However, no NAP1 (ribotype 027) isolate could be discovered in this study.