Molecular epidemiology of community- and hospital-associated Clostridioides difficile infections in Jönköping, Sweden, October 2017 - March 2018.

Autor: Enkirch T; Public Health Agency of Sweden, Solna, Sweden.; European Programme for Public Health Microbiology Training (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden., Mernelius S; Laboratory Medicine, Region Jönköping County, Jönköping, Sweden.; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden., Magnusson C; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.; Department of Infectious Diseases, Region Jönköping County, Jönköping, Sweden., Kühlmann-Berenzon S; Public Health Agency of Sweden, Solna, Sweden., Bengnér M; Office for Control of Communicable Diseases, Region Jönköping County, Jönköping, Sweden., Åkerlund T; Public Health Agency of Sweden, Solna, Sweden., Rizzardi K; Public Health Agency of Sweden, Solna, Sweden.
Jazyk: angličtina
Zdroj: APMIS : acta pathologica, microbiologica, et immunologica Scandinavica [APMIS] 2022 Nov; Vol. 130 (11), pp. 661-670. Date of Electronic Publication: 2022 Sep 06.
DOI: 10.1111/apm.13270
Abstrakt: Clostridioides difficile infections (CDIs) in Sweden are mostly hospital-associated (HA) with limited knowledge regarding community-associated (CA) infections. Here, we investigated the molecular epidemiology of clinical isolates of CA-CDI and HA-CDI in a Swedish county. Data and isolates (n = 156) of CDI patients (n = 122) from Jönköping county, October 2017-March 2018, were collected and classified as CA (without previous hospital care or onset ≤2 days after admission or >12 weeks after discharge from hospital) or HA (onset >3 days after hospital admission or within 4 weeks after discharge). Molecular characterization of isolates included PCR ribotyping (n = 156 isolates) and whole genome sequencing with single nucleotide polymorphisms (SNP) analysis (n = 53 isolates). We classified 47 patients (39%) as CA-CDI and 75 (61%) as HA-CDI. Between CA-CDI and HA-CDI patients, we observed no statistically significant differences regarding gender, age, 30-day mortality or recurrence. Ribotype 005 (RR 3.1; 95% CI: 1.79-5.24) and 020 (RR 2.5; 95% CI: 1.31-4.63) were significantly associated with CA-CDI. SNP analysis identified seven clusters (0-2 SNP difference) involving 17/53 isolates of both CA-CDI and HA-CDI. Molecular epidemiology differed between CA-CDI and HA-CDI and WGS analysis suggests transmission of CDI within and between hospitals and communities.
(© 2022 The Authors. APMIS published by John Wiley & Sons Ltd on behalf of Scandinavian Societies for Pathology, Medical Microbiology and Immunology.)
Databáze: MEDLINE
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