Emergence of Clostridium difficile ribotype 027 in Korea

Heejung Kim, Yangsoon Lee, Hee Won Moon, Chae Seung Lim, Kyungwon Lee, Yunsop Chong

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background: Clostridium difficile infection (CDI) has markedly risen and is associated with hypervirulent ribotype 027 outbreaks in North America and Europe since 2003. The aims of this study were to determine the prevalence of ribotype 027 among C. difficile isolates in Korea, to characterize the ribotype 027 isolates, and to determine the clinical severity of CDI in patients infected with these isolates. Methods: A total of 1,251 isolates of C difficile recovered from stool specimens of suspected CDI patients at two tertiary-care hospitals and one commercial laboratory between 2002 and 2009. Genes for toxin A [tcdA), toxin B (tcdB), and binary toxin (cdtA and cdtB) were detected by PCR. Mutation in the tcdC gene was detected by sequencing after PCR amplification. For molecular genotyping, we performed PCR-ribotyping, pulsed-field gel electrophoresis (PFGE), and multilocus variable-number tandem-repeat analysis (MLVA). Minimum inhibitory concentrations of moxifloxacin were determined using Etest strips (AB bioMérieux, Sweden). Results: We identified 7 isolates as ribotype 027. These isolates had the same tcdC mutation as the epidemic strain, and 6 of them were resistant to moxifloxacin.The isolates were categorized into 3 different PFGE types and 7 different MLVA types. All the 7 cases had occurred sporadically. Conclusions: C. difficile ribotype 027 is uncommon, but it has emerged in Korea. The spread of this ribotype should be closely monitored in orderte avoid an outbreak of CDI in Korea.

Original languageEnglish
Pages (from-to)191-196
Number of pages6
JournalKorean Journal of Laboratory Medicine
Volume31
Issue number3
DOIs
Publication statusPublished - 2011 Jul 1

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Ribotyping
Clostridium
Clostridium difficile
Korea
Clostridium Infections
Minisatellite Repeats
Electrophoresis
Genes
Gels
Pulsed Field Gel Electrophoresis
Polymerase Chain Reaction
Disease Outbreaks
Disk Diffusion Antimicrobial Tests
Amplification
Mutation
Microbial Sensitivity Tests
Tertiary Healthcare
North America
Sweden
Tertiary Care Centers

Keywords

  • Clostridium difficile
  • Multilocus variable-number tandem-repeat analysis
  • PCR-ribotype 027
  • Pulsed-field gel electrophoresis

ASJC Scopus subject areas

  • Biochemistry, medical
  • Clinical Biochemistry

Cite this

Emergence of Clostridium difficile ribotype 027 in Korea. / Kim, Heejung; Lee, Yangsoon; Moon, Hee Won; Lim, Chae Seung; Lee, Kyungwon; Chong, Yunsop.

In: Korean Journal of Laboratory Medicine, Vol. 31, No. 3, 01.07.2011, p. 191-196.

Research output: Contribution to journalArticle

Kim, Heejung ; Lee, Yangsoon ; Moon, Hee Won ; Lim, Chae Seung ; Lee, Kyungwon ; Chong, Yunsop. / Emergence of Clostridium difficile ribotype 027 in Korea. In: Korean Journal of Laboratory Medicine. 2011 ; Vol. 31, No. 3. pp. 191-196.
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abstract = "Background: Clostridium difficile infection (CDI) has markedly risen and is associated with hypervirulent ribotype 027 outbreaks in North America and Europe since 2003. The aims of this study were to determine the prevalence of ribotype 027 among C. difficile isolates in Korea, to characterize the ribotype 027 isolates, and to determine the clinical severity of CDI in patients infected with these isolates. Methods: A total of 1,251 isolates of C difficile recovered from stool specimens of suspected CDI patients at two tertiary-care hospitals and one commercial laboratory between 2002 and 2009. Genes for toxin A [tcdA), toxin B (tcdB), and binary toxin (cdtA and cdtB) were detected by PCR. Mutation in the tcdC gene was detected by sequencing after PCR amplification. For molecular genotyping, we performed PCR-ribotyping, pulsed-field gel electrophoresis (PFGE), and multilocus variable-number tandem-repeat analysis (MLVA). Minimum inhibitory concentrations of moxifloxacin were determined using Etest strips (AB bioM{\'e}rieux, Sweden). Results: We identified 7 isolates as ribotype 027. These isolates had the same tcdC mutation as the epidemic strain, and 6 of them were resistant to moxifloxacin.The isolates were categorized into 3 different PFGE types and 7 different MLVA types. All the 7 cases had occurred sporadically. Conclusions: C. difficile ribotype 027 is uncommon, but it has emerged in Korea. The spread of this ribotype should be closely monitored in orderte avoid an outbreak of CDI in Korea.",
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