Hsiao-Lun Wei1, Sung-Hsi Wei2, Chien-Wen Huang3, Chih-Hung Shih4, Yi-Wen Huang5, Min-Chi Lu6, Jin-Chyr Hsu7, Yi-Sheng Liou8, Chien-Shun Chiou9. 1. The Central Region Laboratory, Centers for Disease Control, Taichung, Taiwan. 2. The Third Branch Office, Centers for Disease Control, Taichung, Taiwan. 3. Fongyuan Hospital, Taichung, Taiwan. 4. Nantou Hospital, Nantou County, Taiwan. 5. Changhua Hospital, Changhua County, Taiwan. 6. Chung Shan Medical University Hospital, Taichung, Taiwan. 7. Taichung Hospital, Taichung, Taiwan. 8. Puli Veterans Hospital, Nantou, Taiwan. 9. The Central Region Laboratory, Centers for Disease Control, Taichung, Taiwan. Electronic address: nipmcsc@cdc.gov.tw.
Abstract
BACKGROUND/ 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. MATERIALS AND 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.
BACKGROUND/ 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. MATERIALS AND 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. difficileinfection (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.
Authors: Panayiotis D Ziakas; Ioannis M Zacharioudakis; Fainareti N Zervou; Christos Grigoras; Elina Eleftheria Pliakos; Eleftherios Mylonakis Journal: PLoS One Date: 2015-02-23 Impact factor: 3.240