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Clinical characterization of Clostridium difficile-associated diarrhea in human immunodeficiency virusinfected inpatients in Shanghai |
JIN Xin1, QIAN Xue-Qin1, HU Lu-Yin1, LI Xin1, SHEN Fang1,2 |
1. Clinical Laboratory, Shanghai Public Health Clinical Center, Shanghai 201508, China; 2. Clinical Laboratory, Shanghai Fifth People’s Hospital, Shanghai 200240, China |
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Abstract To investigate Clostridium difficile (C. difficile)associated diarrhea (CDAD) in human immunodeficiency virus (HIV)infected inpatients in Shanghai, C. difficile and general intestinal tract pathogenic bacteria were isolated by selective medium from abnormal fecal specimens collected from 250 HIV infected inpatients from March 2012 to March 2013. The susceptibilities of C. difficile to metronidazole, vancomycin, clindamycin and moxifloxacin were determined by E-test method. Molecular typing was performed by multilocus sequence typing (MLST). The genes tcdA and tcdB of toxins A and B were detected by conventional polymerase chain reaction (PCR). 29 clinical strains of C. difficile were isolated from 250 fecal specimens (11.6%), in which 17 strains were tcdA+/tcdB+ and 12 strains were tcdA-/tcdB-. All strains were susceptible to metronidazole and vancomycin. Resistance to clindamycin and moxifloxacin was found in 69.0% and 31.0% strains respectively. A total of 12 different sequence types (ST2, 3, 7, 8, 26, 35, 37, 38, 39, 54, 81, and 124) were identified. The most prevalent ST types were ST54 (6/29, 20.7%) and ST39 (5/29, 17.2%). The results suggest that the rate of positive C. difficile detection is high and should be monitored strictly to prevent outbreak.
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Received: 12 November 2014
Published: 25 October 2015
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Corresponding Authors:
SHEN Fang
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