Open AccessPredominance of Clostridium difficile Ribotypes 017 and 078 among Toxigenic Clinical Isolates in Southern Taiwan
Author(s) -
YuanPin Hung,
I-Hsiu Huang,
HongRu Lin,
BoYang Tsai,
Hsiao-Chieh Liu,
Hsiu-Chuan Liu,
Jen-Chieh Lee,
Yi-Hui Wu,
Pei-Jane Tsai,
Wen Chien Ko
Publication year - 2016
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0166159
Subject(s) - clostridium difficile , microbiology and biotechnology , clostridium difficile toxin a , genotype , diarrhea , biology , enterotoxin , pore forming toxin , toxin , clostridium difficile toxin b , ribotyping , virology , colonization , medicine , gene , genetics , antibiotics , microbial toxins , escherichia coli
Ribotypes and toxin genotypes of clinical C . difficile isolates in Taiwan are rarely reported. A prospective surveillance study from January 2011 to January 2013 was conducted at the medical wards of a district hospital in southern Taiwan. Of the first toxigenic isolates from 120 patients, 68 (56.7%) of 120 isolates possessed both tcdA and tcdB . Of 52 (43.3%) with tcdB and truncated tcdA ( tcdA -/ tcdB +), all were ribotype 017 and none had binary toxin or tcdC deletion. Eighteen (15%) toxigenic isolates harbored binary toxins ( cdtA and cdtB ) and all had tcdC deletion, including Δ39 (C184T) deletion (14 isolates), Δ18 in-frame deletion (3 isolates), and Δ18 (Δ117A) deletion (1 isolate). Eleven of 14 isolates with Δ39 (C184T) deletion belonged to the ribotype 078 family, including ribotype 127 (6 isolates), ribotype 126 (4 isolates), and ribotype 078 (1 isolate). Among 8 patients with consecutive C . difficile isolates, these isolates from 6 (75%) patients were identical, irrespective of the presence or absence of diarrhea, suggestive of persistent fecal carriage or colonization. In conclusion in southern Taiwan, ribotype 017 isolates with a tcdA -/ tcdB + genotype were not uncommon and of C . difficile isolates with binary toxin, the ribotype 078 family was predominant.