Multi Locus Sequence Typing of Clostridioides difficile Isolates in Liver Transplant Recipients

سال انتشار: 1398
نوع سند: مقاله کنفرانسی
زبان: انگلیسی
مشاهده: 299

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شناسه ملی سند علمی:

ICCM13_072

تاریخ نمایه سازی: 25 آبان 1398

چکیده مقاله:

Background and objectives: Clostridioides difficile infection (CDI) is a disease with an array of clinical symptoms ranging from mild diarrhea to toxic megacolon, to the perforation of the colon, pseudomembrane colitis, or even death. The epidemiology of C.difficile has dramatically changed over the past decades, partly due to the emergence of specific strains with increased toxin production and resistance to antibiotic. The objective of this study was to determine circulating C.difficile strains among liver transplant recipients. Materials and methods: This study was done on 39 C.difficile strains isolated through anaerobic toxigenic culture from liver transplant recipients who were admitted to the Transplant Intensive Care Unit (ICU) at Namazi hospital between October 2016 and July 2017. All isolates were further characterized by PCR-based Multi Locus Sequence Typing (MLST). MLST was performed using seven housekeeping genes (adk, atpA, dxr, glyA, recA, sodA and tpi). Sequencing was done using specific primers for each gene and the sequences of the allele were submitted to the MLST database homepage. Allele numbers, clades and sequence types (STs) were assigned by the C. difficile MLST website (http://pubmlst.org/cdifficile/). Results: MLST revealed 18 distinct STs, including a new one. Two predominant sequence types (STs) were detected among the isolates: ST-48 (23.1%) and ST-16 (12.8%). Four sequence types had the frequency of more than one: ST-3 (n=3), ST-55 (n=3), ST-16 (n=2) and ST-107(n=2). One new allele (glyA 62) and one new ST (ST-540) were assigned after data submission to pubmlst Clostridioides difficile database curators. All the sequence types belonged to clade I, except for the ST-375, which belonged to clade IV. Conclusions: Results of this study showed that specific sequence types were circulating among the patients of focus. This finding suggests that C.difficile isolates could be transmitted directly from patient to patient, or indirectly via shared environment and instruments during the hospital stay. Improvement in infection prevention strategies is needed to reduce the spread of C.difficile in hospital settings. CDI.

نویسندگان

Nasrin Firoozian

Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Fars, Iran.

Seyed Ali Malek-Hosseini

Shiraz Organ Transplant Center, Avicenna Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

Fereshteh Fani

Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Fars, Iran.

Maneli Aminshahidi

Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Fars, Iran.