Characterization of Clostridium difficile Strains in British Columbia, Canada: A Shift from NAP1 Majority (2008) to Novel Strain Types (2013) in One Region

Autor: Agatha N. Jassem, Natalie Prystajecky, Fawziah Marra, Pamela Kibsey, Kennard Tan, Patricia Umlandt, Loretta Janz, Sylvie Champagne, Bruce Gamage, George R. Golding, Michael R. Mulvey, Bonnie Henry, Linda M. N. Hoang
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Zdroj: Canadian Journal of Infectious Diseases and Medical Microbiology, Vol 2016 (2016)
Druh dokumentu: article
ISSN: 1712-9532
1918-1493
DOI: 10.1155/2016/8207418
Popis: Background. Clostridium difficile is a major cause of gastrointestinal illness. Epidemic NAP1 strains contain toxins A and B, a deletion in repressor tcdC, and a binary toxin. Objectives. To determine the molecular epidemiology of C. difficile in British Columbia and compare between two time points in one region. Methods. C. difficile isolates from hospital and community laboratories (2008) and one Island Health hospital laboratory (2013) were characterized by pulsed-field gel electrophoresis, PCR-ribotyping, toxin possession, tcdC genotype, and antimicrobial susceptibility. Results. In 2008, 42.7% of isolates had NAP1 designation. Hospital-collected isolates were associated with older patients and more NAP1 types. Unlike other isolates, most NAP1 isolates possessed binary toxin and a 19 bp loss in tcdC. All isolates were susceptible to metronidazole and vancomycin. A 2013 follow-up revealed a 28.9% decrease in NAP1 isolates and 20.0% increase in isolates without NAP designation in one region. Then, community-associated cases were seen in younger patients, while NAP types were evenly distributed. Isolates without NAP designation did not cluster with a PFGE pattern or ribotype. Conclusions. Evaluation of C. difficile infections within British Columbia revealed demographic associations, epidemiological shifts, and characteristics of strain types. Continuous surveillance of C. difficile will enable detection of emerging strains.
Databáze: Directory of Open Access Journals
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