國家衛生研究院 NHRI:Item 3990099045/10925
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    題名: Ribotypes and antimicrobial susceptibility among clinical toxigenic Clostridium difficile isolates in Taiwan
    作者: Hung, YP;Lee, YT;Tang, HJ;Lin, HJ;Liu, HC;Lee, JC;Tsai, PJ;Tsai, BY;Hsueh, PR;Ko, WC
    貢獻者: National Institute of Infectious Diseases and Vaccinology
    摘要: Background: Some Clostridium difficile hypervirulent strains, including RT027 and RT126 had been reported in Taiwan. The data of toxin gene or ribotype distribution of toxigenic C. difficile isolates in Taiwan remain limited. Methods: The study was conducted from January 2015 to December 2016 in five hospitals in Taiwan. Stool culture for C. difficile was done in fecal sample from patients with diarrhea. Multiplex PCR was used to detect tcdA, tcdB, cdtA, cdtB, and tcdC deletion, and antimicrobial susceptibility was investigated in toxigenic C. difficile isolates. Ribotypes (RTs) of those isolates with tcdC deletion and tcdA-/tcdB+ were determined. Results: Of 1199 C. difficile isolates collected from five hospitals, 904 isolates were toxigenic: tcdA+/tcdB+ (794, 87.8%) and tcdA-/tcdB+ (110, 12.2%). Of the toxigenic isolates, 81 (9.0%) isolates had tcdC deletion and binary toxin, i.e., hypervirulent isolates. RT078 family (61 isolates: 75.3%, including RT033, RT078, RT126, and RT127) and RT027 family (15: 18.5%, including RT027, RT034, and RT075) were predominant. Of 110 tcdA-/tcdB+ isolates, 100 (90.9%) isolates were identified as RT017. Metronidazole and vancomycin resistance, though rare, was present in 1.2% and 2.0%, respectively, of toxigenic isolates, and of note there were 9 isolates resistant to both metronidazole and vancomycin. Irrespective of toxigenic or non-toxigenic isolates, MIC 90 of doxycycline (8 μg/mL) was higher than that of tigecycline (≤0.0625 μg/mL), suggestive of more potent antibacterial activity of tigecycline than doxycycline. Conclusion: Hypervirulent isolates accounted for 9% of toxigenic isolates in Taiwan, and the dominant ribotypes were RT078 and RT027 family. Metronidazole or vancomycin remains active against the vast majority of C. difficile isolates.
    日期: 2017-11
    關聯: International Journal of Antimicrobial Agents. 2017 Nov;50(Suppl. 2):S115.
    Link to: http://dx.doi.org/10.1016/S0924-8579(17)30423-5
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0924-8579&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000416028900270
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