Molecular epidemiology of Clostridium difficile infection in Iranian hospitals

被引:22
作者
Shoaei, Parisa [1 ]
Shojaei, Hasan [2 ]
Khorvash, Farzin [1 ]
Hosseini, Sayed Mohsen [3 ]
Ataei, Behrooz [4 ]
Tavakoli, Hossein [5 ]
Jalali, Mohammad [6 ]
Weese, J. Scott [7 ]
机构
[1] Isfahan Univ Med Sci, Nosocomial Infect Res Ctr, Esfahan, Iran
[2] Isfahan Univ Med Sci, Sch Med, Dept Microbiol, Esfahan, Iran
[3] Isfahan Univ Med Sci, Epidemiol & Biostat Dept, Esfahan, Iran
[4] Isfahan Univ Med Sci, Infect Dis & Trop Med Res Ctr, Esfahan, Iran
[5] Univ British Columbia, Dept Biol, Kelowna, BC, Canada
[6] Isfahan Univ Med Sci, Sch Food Sci & Nutr, Esfahan, Iran
[7] Univ Guelph, Dept Pathobiol, Ontario Vet Coll, Guelph, ON, Canada
关键词
Clostridium difficile infection; Molecular characterization; Risk factor; Multilocus sequence typing analysis (MLST); SEQUENCE TYPING ANALYSIS; STRAINS; TRANSMISSION; RESISTANCE;
D O I
10.1186/s13756-018-0454-6
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
BackgroundClostridium difficile infection (CDI) is known as one of the most important causes of nosocomial infections. The main objective of this study was to evaluate the presence of Clostridium difficile in the stool of hospitalized patients with diarrhea as well as in their environments.MethodsC. difficile isolates were characterized according to the presence of toxin genes and antibiotic resistance. Multilocus Sequence Typing Analysis (MLST) was applied for finding the genetic polymorphism and relationship among strain lineages.ResultsA total of 821 samples (574 stools and 247 swabs) were collected between April 2015 and May 2017. The prevalence of C. difficile isolates was 28.6% (164/574) in patients and 19% (47/247) in swabs taken from medical devices, hands of healthcare workers and skin patient sites. Finally, 11.5% (66/574) toxigenic C. difficile strains isolated from stool samples of inpatients and 4.4% (11/247) from hands of healthcare workers and skin patient sites. All the toxigenic isolates were inhibited by a low concentration of vancomycin (MIC <0.5g/ml). About 43% (33/77) and 39% of isolates were resistant to Clindamycin and moxifloxacin respectively. All isolates were susceptible to metronidazole. Toxigenic C. difficile strains were analyzed by MLST and were divided into 4 different STs. The detected types were ST-54 (57.9%), followed by ST-2 (31.6. %), ST-15 (5.3%) and ST-37 (5.3%), while none of the isolates were identified as ST-1 or ST-11. Significant risk factors for CDI appear to be advanced age, undergoing chemotherapy, previous surgery, and residence in the nursing home.ConclusionsCDI is common in Iran and further studies are recommended to monitor its epidemiological variations. Moreover, greater attempts must be made to encourage antibiotic stewardship by healthcare workers and the public.
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页数:7
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