Different molecular characteristics and antimicrobial resistance profiles of Clostridium difficile in the Asia-Pacific region

Authors

Yun Luo
Elaine Cheong
Qiao Bian
Deirdre A. Collins, Edith Cowan UniversityFollow
Julian Ye
Jeong Hwan Shin
Wing Cheong Yam
Tohru Takata
Xiaojun Song
Xianjun Wang
Mini Kamboj
Thomas Gottlieb
Jianmin Jiang
Thomas V. Riley, Edith Cowan UniversityFollow
Yi-Wei Tang
Dazhi Jin

Document Type

Journal Article

Publication Title

Emerging Microbes and Infections

Publisher

Taylor and Francis

School

School of Medical and Health Sciences

RAS ID

30041

Comments

Luo, Y., Cheong, E., Bian, Q., Collins, D. A., Ye, J., Shin, J. H., ... Jin, D. (2019). Different molecular characteristics and antimicrobial resistance profiles of Clostridium difficile in the Asia-Pacific region. Emerging Microbes and Infections, 8, 1553-1562. Available here

Abstract

Molecular epidemiology of Clostridium difficile infection (CDI) has been extensively studied in North America and Europe; however, limited data on CDI are available in the Asia-Pacific region. A multicentre retrospective study was conducted in this region. C. difficile isolates were subjected to multilocus sequence typing (ST) and antimicrobial susceptibility testing. Totally, 394 isolates were collected from Hangzhou, Hong Kong, China; Busan, South Korea; Fukuoka, Japan; Singapore; Perth, Sydney, Australia; New York, the United States. C. difficile isolates included 337 toxin A-positive/B-positive/binary toxin-negative (A+B+CDT-), 48 A-B+CDT-, and nine A+B+CDT+. Distribution of dominant STs varied geographically with ST17 in Fukuoka (18.6%), Busan (56.0%), ST2 in Sydney (20.4%), Perth (25.8%). The antimicrobial resistance patterns were significantly different among the eight sites (χ2 = 325.64, p < 0.001). Five major clonal complexes correlated with unique antimicrobial resistances. Healthcare-associated (HA) CDI was mainly from older patients with more frequent antimicrobial use and higher A-B+ positive rates. Higher resistance to gatifloxacin, tetracycline, and erythromycin were observed in HA-CDI patients (χ2 = 4.76-7.89, p = 0.005-0.029). In conclusion, multiple C. difficile genotypes with varied antimicrobial resistance patterns have been circulating in the Asia-Pacific region. A-B+ isolates from older patients with prior antimicrobial use were correlated with HA-CDI.

Additional Information

This study was presented in part at the 16th Asia Pacific Congress of Clinical Microbiology & Infection, Melbourne, Australia, 30 November to 3 December 2016.

DOI

10.1080/22221751.2019.1682472

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.