Molecular Characterization of Clostridium difficile Isolates from Human Subjects and the Environment
Clostridium difficile is a spore-forming, gram-positive, anaerobic bacillus that can cause C. difficile infection (CDI). However, only a few studies on the prevalence and antibiotic resistance of C. difficile in healthy individuals in China have been reported. We employed a spore enrichment culture...
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| description | Clostridium difficile is a spore-forming, gram-positive, anaerobic bacillus that can cause C. difficile infection (CDI). However, only a few studies on the prevalence and antibiotic resistance of C. difficile in healthy individuals in China have been reported. We employed a spore enrichment culture to screen for C. difficile in the stool samples of 3699 healthy Chinese individuals who were divided into 4 groups: infants younger than 2 years of age and living at home with their parents; children aged 1 to 8 years of age and attending three different kindergarten schools; community-dwelling healthy adult aged 23-60 years old; and healthcare workers aged 28-80 years old. The C. difficile isolates were analyzed for the presence of toxin genes and typed by PCR ribotyping and multilocus sequence typing (MLST). The minimum inhibitory concentration of 8 antimicrobial agents was determined for all of the isolates using the agar dilution method. The intestinal carriage rate in the healthy children was 13.6% and ranged from 0% to 21% depending on age. The carriage rates in the 1654 community-dwelling healthy adults and 348 healthcare workers were 5.5% and 6.3%, respectively. Among the isolates, 226 were toxigenic (225 tcdA+/tcdB+ and 1 tcdA+/tcdB+ ctdA+/ctdB+). Twenty-four ribotypes were found, with the dominant type accounting for 29.7% of the isolates. The toxigenic isolates were typed into 27 MLST genotypes. All of the strains were susceptible to vancomycin, metronidazole, fidaxomicin, and rifaximin. High resistance to levofloxacin and ciprofloxacin at rates of 39.8% and 98.3%, respectively, were observed. ST37 isolates were more resistant to levofloxacin than the other STs. The PCR ribotypes and sequence types from the healthy populations were similar to those from the adult patients. |
| doi_str_mv | 10.1371/journal.pone.0151964 |
| format | Article |
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However, only a few studies on the prevalence and antibiotic resistance of C. difficile in healthy individuals in China have been reported. We employed a spore enrichment culture to screen for C. difficile in the stool samples of 3699 healthy Chinese individuals who were divided into 4 groups: infants younger than 2 years of age and living at home with their parents; children aged 1 to 8 years of age and attending three different kindergarten schools; community-dwelling healthy adult aged 23-60 years old; and healthcare workers aged 28-80 years old. The C. difficile isolates were analyzed for the presence of toxin genes and typed by PCR ribotyping and multilocus sequence typing (MLST). The minimum inhibitory concentration of 8 antimicrobial agents was determined for all of the isolates using the agar dilution method. The intestinal carriage rate in the healthy children was 13.6% and ranged from 0% to 21% depending on age. The carriage rates in the 1654 community-dwelling healthy adults and 348 healthcare workers were 5.5% and 6.3%, respectively. Among the isolates, 226 were toxigenic (225 tcdA+/tcdB+ and 1 tcdA+/tcdB+ ctdA+/ctdB+). Twenty-four ribotypes were found, with the dominant type accounting for 29.7% of the isolates. The toxigenic isolates were typed into 27 MLST genotypes. All of the strains were susceptible to vancomycin, metronidazole, fidaxomicin, and rifaximin. High resistance to levofloxacin and ciprofloxacin at rates of 39.8% and 98.3%, respectively, were observed. ST37 isolates were more resistant to levofloxacin than the other STs. The PCR ribotypes and sequence types from the healthy populations were similar to those from the adult patients.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0151964</identifier><identifier>PMID: 27011211</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Adults ; Agar ; Age ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents - pharmacology ; Anti-Bacterial Agents - therapeutic use ; Anti-infective agents ; Antibiotic resistance ; Antibiotics ; Antimicrobial agents ; Bacteria ; Biology and Life Sciences ; Causes of ; Child ; Child, Preschool ; Children ; China - epidemiology ; Ciprofloxacin ; Clostridium difficile ; Clostridium difficile - drug effects ; Clostridium difficile - genetics ; Clostridium difficile - isolation & purification ; Communities ; Deoxyribonucleic acid ; Diarrhea ; Dilution ; DNA ; Drug Resistance, Bacterial ; Enterocolitis, Pseudomembranous - drug therapy ; Enterocolitis, Pseudomembranous - epidemiology ; Enterocolitis, Pseudomembranous - microbiology ; Female ; Genetic aspects ; Genotypes ; Glycerol ; Health aspects ; Health care ; High resistance ; Hospitals ; Humans ; Infant ; Infants ; Infections ; Intestine ; Intestines - microbiology ; Laboratories ; Levofloxacin ; Male ; Maternal & child health ; Medical personnel ; Medicine and Health Sciences ; Metronidazole ; Microbial Sensitivity Tests ; Middle Aged ; Minimum inhibitory concentration ; Multilocus Sequence Typing ; Parents ; People and Places ; Physiological aspects ; Prevalence ; Ribotyping ; Schools ; Studies ; Vancomycin ; Workers ; Young Adult</subject><ispartof>PloS one, 2016-03, Vol.11 (3), p.e0151964</ispartof><rights>COPYRIGHT 2016 Public Library of Science</rights><rights>2016 Tian et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2016 Tian et al 2016 Tian et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-afcce8a4dded2bd7eee54fb3204e48be01f44873774254e8784aa00fb4d655563</citedby><cites>FETCH-LOGICAL-c692t-afcce8a4dded2bd7eee54fb3204e48be01f44873774254e8784aa00fb4d655563</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4807052/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4807052/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27011211$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Deshpande, Abhishek</contributor><creatorcontrib>Tian, Tian-tian</creatorcontrib><creatorcontrib>Zhao, Jian-hong</creatorcontrib><creatorcontrib>Yang, Jing</creatorcontrib><creatorcontrib>Qiang, Cui-xin</creatorcontrib><creatorcontrib>Li, Zhi-rong</creatorcontrib><creatorcontrib>Chen, Jing</creatorcontrib><creatorcontrib>Xu, Kai-yue</creatorcontrib><creatorcontrib>Ciu, Qing-qing</creatorcontrib><creatorcontrib>Li, Ru-xin</creatorcontrib><title>Molecular Characterization of Clostridium difficile Isolates from Human Subjects and the Environment</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Clostridium difficile is a spore-forming, gram-positive, anaerobic bacillus that can cause C. difficile infection (CDI). However, only a few studies on the prevalence and antibiotic resistance of C. difficile in healthy individuals in China have been reported. We employed a spore enrichment culture to screen for C. difficile in the stool samples of 3699 healthy Chinese individuals who were divided into 4 groups: infants younger than 2 years of age and living at home with their parents; children aged 1 to 8 years of age and attending three different kindergarten schools; community-dwelling healthy adult aged 23-60 years old; and healthcare workers aged 28-80 years old. The C. difficile isolates were analyzed for the presence of toxin genes and typed by PCR ribotyping and multilocus sequence typing (MLST). The minimum inhibitory concentration of 8 antimicrobial agents was determined for all of the isolates using the agar dilution method. The intestinal carriage rate in the healthy children was 13.6% and ranged from 0% to 21% depending on age. The carriage rates in the 1654 community-dwelling healthy adults and 348 healthcare workers were 5.5% and 6.3%, respectively. Among the isolates, 226 were toxigenic (225 tcdA+/tcdB+ and 1 tcdA+/tcdB+ ctdA+/ctdB+). Twenty-four ribotypes were found, with the dominant type accounting for 29.7% of the isolates. The toxigenic isolates were typed into 27 MLST genotypes. All of the strains were susceptible to vancomycin, metronidazole, fidaxomicin, and rifaximin. High resistance to levofloxacin and ciprofloxacin at rates of 39.8% and 98.3%, respectively, were observed. ST37 isolates were more resistant to levofloxacin than the other STs. The PCR ribotypes and sequence types from the healthy populations were similar to those from the adult patients.</description><subject>Adult</subject><subject>Adults</subject><subject>Agar</subject><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anti-Bacterial Agents - pharmacology</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Anti-infective agents</subject><subject>Antibiotic resistance</subject><subject>Antibiotics</subject><subject>Antimicrobial agents</subject><subject>Bacteria</subject><subject>Biology and Life Sciences</subject><subject>Causes of</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>China - epidemiology</subject><subject>Ciprofloxacin</subject><subject>Clostridium difficile</subject><subject>Clostridium difficile - drug effects</subject><subject>Clostridium difficile - genetics</subject><subject>Clostridium difficile - isolation & purification</subject><subject>Communities</subject><subject>Deoxyribonucleic acid</subject><subject>Diarrhea</subject><subject>Dilution</subject><subject>DNA</subject><subject>Drug Resistance, Bacterial</subject><subject>Enterocolitis, Pseudomembranous - drug therapy</subject><subject>Enterocolitis, Pseudomembranous - epidemiology</subject><subject>Enterocolitis, Pseudomembranous - microbiology</subject><subject>Female</subject><subject>Genetic aspects</subject><subject>Genotypes</subject><subject>Glycerol</subject><subject>Health aspects</subject><subject>Health care</subject><subject>High resistance</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infant</subject><subject>Infants</subject><subject>Infections</subject><subject>Intestine</subject><subject>Intestines - microbiology</subject><subject>Laboratories</subject><subject>Levofloxacin</subject><subject>Male</subject><subject>Maternal & child health</subject><subject>Medical personnel</subject><subject>Medicine and Health Sciences</subject><subject>Metronidazole</subject><subject>Microbial Sensitivity Tests</subject><subject>Middle Aged</subject><subject>Minimum inhibitory concentration</subject><subject>Multilocus Sequence Typing</subject><subject>Parents</subject><subject>People and Places</subject><subject>Physiological aspects</subject><subject>Prevalence</subject><subject>Ribotyping</subject><subject>Schools</subject><subject>Studies</subject><subject>Vancomycin</subject><subject>Workers</subject><subject>Young 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Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tian, Tian-tian</au><au>Zhao, Jian-hong</au><au>Yang, Jing</au><au>Qiang, Cui-xin</au><au>Li, Zhi-rong</au><au>Chen, Jing</au><au>Xu, Kai-yue</au><au>Ciu, Qing-qing</au><au>Li, Ru-xin</au><au>Deshpande, Abhishek</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Molecular Characterization of Clostridium difficile Isolates from Human Subjects and the Environment</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2016-03-24</date><risdate>2016</risdate><volume>11</volume><issue>3</issue><spage>e0151964</spage><pages>e0151964-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Clostridium difficile is a spore-forming, gram-positive, anaerobic bacillus that can cause C. difficile infection (CDI). However, only a few studies on the prevalence and antibiotic resistance of C. difficile in healthy individuals in China have been reported. We employed a spore enrichment culture to screen for C. difficile in the stool samples of 3699 healthy Chinese individuals who were divided into 4 groups: infants younger than 2 years of age and living at home with their parents; children aged 1 to 8 years of age and attending three different kindergarten schools; community-dwelling healthy adult aged 23-60 years old; and healthcare workers aged 28-80 years old. The C. difficile isolates were analyzed for the presence of toxin genes and typed by PCR ribotyping and multilocus sequence typing (MLST). The minimum inhibitory concentration of 8 antimicrobial agents was determined for all of the isolates using the agar dilution method. The intestinal carriage rate in the healthy children was 13.6% and ranged from 0% to 21% depending on age. The carriage rates in the 1654 community-dwelling healthy adults and 348 healthcare workers were 5.5% and 6.3%, respectively. Among the isolates, 226 were toxigenic (225 tcdA+/tcdB+ and 1 tcdA+/tcdB+ ctdA+/ctdB+). Twenty-four ribotypes were found, with the dominant type accounting for 29.7% of the isolates. The toxigenic isolates were typed into 27 MLST genotypes. All of the strains were susceptible to vancomycin, metronidazole, fidaxomicin, and rifaximin. High resistance to levofloxacin and ciprofloxacin at rates of 39.8% and 98.3%, respectively, were observed. ST37 isolates were more resistant to levofloxacin than the other STs. The PCR ribotypes and sequence types from the healthy populations were similar to those from the adult patients.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>27011211</pmid><doi>10.1371/journal.pone.0151964</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2016-03, Vol.11 (3), p.e0151964 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1775626226 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adult Adults Agar Age Aged Aged, 80 and over Anti-Bacterial Agents - pharmacology Anti-Bacterial Agents - therapeutic use Anti-infective agents Antibiotic resistance Antibiotics Antimicrobial agents Bacteria Biology and Life Sciences Causes of Child Child, Preschool Children China - epidemiology Ciprofloxacin Clostridium difficile Clostridium difficile - drug effects Clostridium difficile - genetics Clostridium difficile - isolation & purification Communities Deoxyribonucleic acid Diarrhea Dilution DNA Drug Resistance, Bacterial Enterocolitis, Pseudomembranous - drug therapy Enterocolitis, Pseudomembranous - epidemiology Enterocolitis, Pseudomembranous - microbiology Female Genetic aspects Genotypes Glycerol Health aspects Health care High resistance Hospitals Humans Infant Infants Infections Intestine Intestines - microbiology Laboratories Levofloxacin Male Maternal & child health Medical personnel Medicine and Health Sciences Metronidazole Microbial Sensitivity Tests Middle Aged Minimum inhibitory concentration Multilocus Sequence Typing Parents People and Places Physiological aspects Prevalence Ribotyping Schools Studies Vancomycin Workers Young Adult |
| title | Molecular Characterization of Clostridium difficile Isolates from Human Subjects and the Environment |
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