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Volume 48, Number 1, February 2015

Molecular typing and epidemiology of Clostridium difficile in respiratory care wards of central Taiwan 


Hsiao-Lun Wei, Sung-Hsi Wei, Chien-Wen Huang, Chih-Hung Shih, Yi-Wen Huang, Min-Chi Lu, Jin-Chyr Hsu, Yi-Sheng Liou, Chien-Shun Chiou


Received: September 1, 2013    Revised: February 27, 2013    Accepted: March 28, 2013   

 

Corresponding author:

* Corresponding author. The Central Region Laboratory, Centers for Disease Control, 5F, 20 Wen-Sin South 3rd Road, Taichung 40855,
Taiwan.
E-mail address: nipmcsc@cdc.gov.tw (C.-S. Chiou) 



 

Background and purpose: 

In industrialized countries, Clostridium difficile is the major cause of nosocomial diarrhea. This study involved a broad overview of baseline epidemiology for C. difficile in Taiwan. 



 

Methods:

Point prevalence was estimated from a prospective survey conducted in the respiratory care wards of six hospitals in central Taiwan. Polymerase chain reaction (PCR) ribotyping and multiple-locus variable-number tandem-repeat analysis (MLVA) were performed on all toxigenic C. difficile isolates, including asymptomatic and symptomatic strains.
 



 

Results:

A total of 149 patients were screened for C. difficile; the point prevalence for C. difficile infection (CDI) and C. difficile colonization was 4% and 19%, respectively. CDI cases were significantly related to end-stage renal disease, and C. difficile colonization cases were significantly associated with previous admission to an acute-care facility. No hypervirulent PCR ribotype 027 strain was found. MLVA detected two clusters of CDI-related and three clusters of asymptomatic C. difficile strains circulating in wards. 



 

Conclusion:

Our results demonstrate a high prevalence of toxigenic C. difficile colonization in hospitals. Infection control personnel should pay attention to the increasing numbers of CDI cases, and molecular typing for C. difficile should be performed when necessary. 



 

Key words:

Clostridium difficile, Molecular typing, Multiple-locus variable-number tandem-repeat analysis (MLVA), Prevalence