Identification of Clostridium difficile RT078 From Patients and Environmental Surfaces in Zhejiang Province, China

No hyper-toxigenic strain was detected in hospital A. According to the tcdC gene sequence, all 8 isolates were identified as ribotype 078, with a mutation point at position 184 and a ∆39-bp deletion (Figure 1). A point mutation at position 184 and ∆39-bp deletion compared with wild-type strain VPI 10463 are shown.TABLE 1 The Incidence of the Binary Toxin-Positive Strains of C. difficile in Three Tertiary Hospitals Clinical Patients Environmental Surfaces Hospital No. of Isolates No. of Binary Toxin-Positive Strains (%) No. of Isolates No. of Binary Toxin-Positive Strains (%) A 33 0 (0) 2 0 (0) B 9 2 (22) 3 1 (33) C 19 2 (11) 32 3 (9) Total 61 4 (7) 37 4 (11) Previously, a few Asian countries and regions have reported the emergence of C. difficile ribotype 078, including Kuwait,2 South Korea,3 Iran,4 Japan,5 and Taiwan.6 The present study is the first to identify ribotype 078 cases not only from patients but also from environmental surfaces in China. Compared with neighboring Japan and Korea, the prevalence of CDI in China remains unclear, mainly due to a lack of awareness in the healthcare system.7 Many clinicians are accustomed to diagnosing patients with antibiotic-associated diarrhea by experience rather than by the results of stool cultures.