The first two Clostridium difficile Ribotype 027/ST1 isolates identified in Beijing, China-an emerging problem or a neglected threat?

Jing Wei Cheng, Meng Xiao, Timothy Kudinha, Zhi Peng Xu, Xin Hou, Lin Ying Sun, Li Zhang, Xin Fan, Fanrong Kong, Ying Chun Xu

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Abstract

Clostridium difficile hyper-virulent ribotype 027 strain has become a significant concern globally, but has rarely been reported in Asian countries including China. Recently, a retrospective single-center study in Beijing, China, detected two ribotype 027 C. difficile isolates from two patients coming for outpatient visits in 2012 and 2013. We performed a systematic investigation of the two isolates (and patients). Both C. difficile isolates had the typical PCR ribotype 027 profile; were positive for tcdA, tcdB and binary toxin genes; belonged to multilocus sequence type 1 (ST1); had typical ribotype 027 deletions in the tcdC gene; and were highly-resistant to fluoroquinolones; but had a different MLVA profile and were not genetically related to any previously reported international ribotype 027 clones. A review of the patients’ medical records showed that neither received appropriate antimicrobial treatment and were lost to follow-up after outpatient visits. We propose that C. difficile infections caused by ribotype 027 are probably a neglected problem in China and the subsequent impact of unawareness of this problem is worrying. Appropriate testing assays and multi-center or national level surveillance for C. difficile infections and specifically for ribotype 027 should be introduced to provide essential data and guide future clinical practice.

Original languageEnglish
Article number18834
Pages (from-to)1-8
Number of pages8
JournalScientific Reports
Volume6
DOIs
Publication statusPublished - 07 Jan 2016

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