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Article: Clostridium difficile isolates with increased sporulation: Emergence of PCR ribotype 002 in Hong Kong
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TitleClostridium difficile isolates with increased sporulation: Emergence of PCR ribotype 002 in Hong Kong
 
AuthorsCheng, VCC2 2
Yam, WC2
Lam, OTC2
Tsang, JLY2
Tse, EYF2
Siu, GKH2
Chan, JFW2
Tse, H2 1
To, KKW2 1
Tai, JWM2
Ho, PL2 1
Yuen, KY2 1
 
KeywordsBiomedicine
Medical Microbiology
Internal Medicine
 
Issue Date2011
 
PublisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/10096/index.htm
 
CitationEuropean Journal Of Clinical Microbiology And Infectious Diseases, 2011, v. 30 n. 11, p. 1371-1381 [How to Cite?]
DOI: http://dx.doi.org/10.1007/s10096-011-1231-0
 
AbstractWe identified a predominant clone of Clostridium difficile PCR ribotype 002, which was associated with an increased sporulation frequency. In 2009, 3,528 stool samples from 2,440 patients were tested for toxigenic C. difficile in a healthcare region in Hong Kong. A total of 345 toxigenic strains from 307 (13.3%) patients were found. Ribotype 002 was the predominant ribotype, which constituted 35 samples from 29 (9.4%) patients. The mean sporulation frequency of ribotype 002 was 20.2%, which was significantly higher than that of the 56 randomly selected ribotypes other than 002 as concurrent controls (3.7%, p<0.001). Patients carrying toxigenic ribotype 002 were more frequently admitted from an elderly home (p=0.01) and received more β-lactam antibiotics in the preceding 3 months compared with the controls (p=0.04) . The identification of toxigenic ribotype 002 in 2009 was temporally related to a significant increase in both the incidence of toxigenic C. difficile from 0.53 to 0.95 per 1,000 admissions (p<0.001) and the rate of positive detection from 4.17% to 6.28% (p<0.001) between period 1 (2004-2008) and period 2 (2009). This finding should alert both the physician and the infection control team to the establishment of and possible outbreaks by ribotype 002 in our hospitals, as in the case of ribotype 027. © 2011 The Author(s).
 
ISSN0934-9723
2012 Impact Factor: 3.024
2012 SCImago Journal Rankings: 0.958
 
DOIhttp://dx.doi.org/10.1007/s10096-011-1231-0
 
PubMed Central IDPMC3191290
 
ISI Accession Number IDWOS:000295864800009
Funding AgencyGrant Number
Food and Health Bureau (FHB) of the Hong Kong SAR Government
Funding Information:

We thank Dr. E.J. Kuijper (Leiden University, the Netherlands) for providing us the standard strains of C. difficile PCR ribotypes used as the positive control. The work was supported by the Research Fund for the Control of Infectious Diseases (RFCID) of the Food and Health Bureau (FHB) of the Hong Kong SAR Government.

 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorCheng, VCC
 
dc.contributor.authorYam, WC
 
dc.contributor.authorLam, OTC
 
dc.contributor.authorTsang, JLY
 
dc.contributor.authorTse, EYF
 
dc.contributor.authorSiu, GKH
 
dc.contributor.authorChan, JFW
 
dc.contributor.authorTse, H
 
dc.contributor.authorTo, KKW
 
dc.contributor.authorTai, JWM
 
dc.contributor.authorHo, PL
 
dc.contributor.authorYuen, KY
 
dc.date.accessioned2012-02-21T05:43:38Z
 
dc.date.available2012-02-21T05:43:38Z
 
dc.date.issued2011
 
dc.description.abstractWe identified a predominant clone of Clostridium difficile PCR ribotype 002, which was associated with an increased sporulation frequency. In 2009, 3,528 stool samples from 2,440 patients were tested for toxigenic C. difficile in a healthcare region in Hong Kong. A total of 345 toxigenic strains from 307 (13.3%) patients were found. Ribotype 002 was the predominant ribotype, which constituted 35 samples from 29 (9.4%) patients. The mean sporulation frequency of ribotype 002 was 20.2%, which was significantly higher than that of the 56 randomly selected ribotypes other than 002 as concurrent controls (3.7%, p<0.001). Patients carrying toxigenic ribotype 002 were more frequently admitted from an elderly home (p=0.01) and received more β-lactam antibiotics in the preceding 3 months compared with the controls (p=0.04) . The identification of toxigenic ribotype 002 in 2009 was temporally related to a significant increase in both the incidence of toxigenic C. difficile from 0.53 to 0.95 per 1,000 admissions (p<0.001) and the rate of positive detection from 4.17% to 6.28% (p<0.001) between period 1 (2004-2008) and period 2 (2009). This finding should alert both the physician and the infection control team to the establishment of and possible outbreaks by ribotype 002 in our hospitals, as in the case of ribotype 027. © 2011 The Author(s).
 
dc.description.naturepublished_or_final_version
 
dc.description.otherSpringer Open Choice, 21 Feb 2012
 
dc.identifier.citationEuropean Journal Of Clinical Microbiology And Infectious Diseases, 2011, v. 30 n. 11, p. 1371-1381 [How to Cite?]
DOI: http://dx.doi.org/10.1007/s10096-011-1231-0
 
dc.identifier.citeulike9144412
 
dc.identifier.doihttp://dx.doi.org/10.1007/s10096-011-1231-0
 
dc.identifier.eissn1435-4373
 
dc.identifier.epage1381
 
dc.identifier.hkuros190822
 
dc.identifier.isiWOS:000295864800009
Funding AgencyGrant Number
Food and Health Bureau (FHB) of the Hong Kong SAR Government
Funding Information:

We thank Dr. E.J. Kuijper (Leiden University, the Netherlands) for providing us the standard strains of C. difficile PCR ribotypes used as the positive control. The work was supported by the Research Fund for the Control of Infectious Diseases (RFCID) of the Food and Health Bureau (FHB) of the Hong Kong SAR Government.

 
dc.identifier.issn0934-9723
2012 Impact Factor: 3.024
2012 SCImago Journal Rankings: 0.958
 
dc.identifier.issue11
 
dc.identifier.openurl
 
dc.identifier.pmcidPMC3191290
 
dc.identifier.pmid21468685
 
dc.identifier.scopuseid_2-s2.0-80054757852
 
dc.identifier.spage1371
 
dc.identifier.urihttp://hdl.handle.net/10722/144876
 
dc.identifier.volume30
 
dc.languageEng
 
dc.publisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/10096/index.htm
 
dc.publisher.placeGermany
 
dc.relation.ispartofEuropean Journal of Clinical Microbiology and Infectious Diseases
 
dc.relation.referencesReferences in Scopus
 
dc.rightsThe Author(s)
 
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License
 
dc.subjectBiomedicine
 
dc.subjectMedical Microbiology
 
dc.subjectInternal Medicine
 
dc.titleClostridium difficile isolates with increased sporulation: Emergence of PCR ribotype 002 in Hong Kong
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong
  2. Queen Mary Hospital Hong Kong