Osong Public Health Res Perspect.
2017 Oct;8(5):325-331. 10.24171/j.phrp.2017.8.5.06.
Characterization of Clostridium difficile Strains Isolated from Patients with C. difficile-associated Disease in Korea
- Affiliations
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- 1Division of Bacterial Disease Research, Center for Infectious Disease Research, Korea National Institute of Health, Cheongju, Korea.
- 2KU Center for Food Safety, College of Veterinary Medicine, Konkuk University, Seoul, Korea.
- 3Department of Biomedical Laboratory Science, College of Medical Sciences, Konyang University, Daejeon, Korea.
- 4Department of Food Science and Technology, Sunchon National University, Suncheon, Korea.
- 5Department of Emergency Medical Services, Sun Moon University, Asan, Korea.
- 6Department of Biomedical Laboratory, Science College of Health Science, Cheongju University, Cheongju, Korea.
- 7Glycobiology Unit, Department of Biological Science, Sungkyunkwan University and Samsung Advanced Institute for Health Science and Technology (SAIHST), Suwon, Korea.
- 8Department of Biomedical Laboratory Science, Kyungdong University, Wonju, Korea. choigo0244@naver.com
- KMID: 2395842
- DOI: http://doi.org/10.24171/j.phrp.2017.8.5.06
Abstract
OBJECTIVES
Studies on Clostridium difficile are rare in Korea. We investigated the epidemiological characteristics of C. difficile isolates from patients with C. difficile-associated disease (CDAD) in Korea.
METHODS
Multiplex polymerase chain reaction was performed to detect the presence of tcdA and tcdB toxin genes. Antimicrobial susceptibility test was carried out by the disk-dilution method. C. difficile strains were subtyped by automated repetitive-element palindromic PCR (rep-PCR).
RESULTS
Among patients with CDAD, 73 (25.8%), 32 (11.3%), 32 (11.3%), and 26 (9.2%) suffered from pneumonia, cancer or neoplasm, diabetes, and colitis, respectively. Of all stool samples, 43 samples (15.2%) were positive for C. difficile strains. We observed two expression patterns of toxin genes: tcdA+/tcdB+ (86% isolates) and tcdA−/tcdB+ (14% isolates), with all isolates expressing tcdB. Furthermore, some isolates were resistant to clindamycin (65%), ampicillin (56%), and cefazolin (40%), but all were susceptible to vancomycin and metronidazole. The tested samples were classified into diverse clusters using automated rep-PCR.
CONCLUSION
Our findings revealed the characteristics and antibiotic resistance of C. difficile isolates from patients in Korea. The epidemiological data may provide valuable insight into development of treatment strategies for C. difficile infections in Korea.
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