Application of multiple-locus variable-number tandem-repeat analysis to determine clonal spread of toxin A-negative Clostridium difficile in a general hospital in Buenos Aires, Argentina.

摘要: Isolates from patients with Clostridium difficile infection (CDI) usually produce both toxin A (TcdA) and B (TcdB), but an increasing number of reports Europe Asia mention infections TcdA-negative, TcdB-positive (A)/B+) strains, characterized as PCR ribotype 017 (type 017). Incidence rates CDI per 10 000 admissions in a 200-bed Argentinean general hospital were 37, 84, 67, 43, 48 42 for the years 2000 to 2005, respectively. The annual percentages type 7.7%, 64.6%, 91.4%, 92.0%, 75.0% 86.4%, Comparison 112 017-CDI 41 non-017-CDI revealed that more often male (68.8% vs. 46.3%; odds ratio 2.55, 95% confidence interval 1.23–5.50). All strains tested belonged toxinotype VIII had 1.8-kb deletion tcdA. In addition, 90% isolates high-level resistance clindamycin erythromycin, determined by presence ermB gene. Multiple-locus variable-number tandem-repeat analysis (MLVA) was applied 56 15 seven other countries. Country-specific clonal complexes found each country. Among isolates, four recognized, accounting 61% all isolates. These did not show correlation over time, seemed be restricted specific wards, mainly internal medicine pulmonology wards. total 56% recurrent caused different isolate, despite identification identical PCR-ribotype. We conclude C. gradually replaced circulating ribotypes MLVA provides detailed insight into nosocomial spread.