Nosocomial transmission of Clostridium difficile ribotype 027 in a Chinese hospital, 2012–2014, traced by whole genome sequencing

BMC Genomics

Research Article

Guiling Han¹  Jing Wang¹  Qingming Ding¹  Jing Zhang¹  Yongtong Cao¹  Hongbing Jia¹  Hui Yang¹  Zhiyuan Yao¹  Chen Chen²  Yuanyuan Zhang²  Pengcheng Du²  Ying Cheng³  Frédéric Barbut⁴  Zhen Wang⁵  Yujun Qiang⁵  Haiyin Wang⁵  Wen Zhang⁵  Na Han⁵  George F. Gao⁶ 

[1] Department of clinical laboratory, China-Japan Friendship Hospital, No. 2 Yinghua Dongjie, Chaoyang, 100029, Beijing, China;Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, and Beijing Key Laboratory of Emerging infectious Diseases, No. 8 Jingshundongjie, 100015, Beijing, China;State Key Laboratory for Infectious Disease Prevention and Control, and National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 102206, Beijing, China;Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping, 102206, Beijing, China;National Reference Laboratory for Clostridium difficile, Faculté de Médecine Pierre et Marie Curie and Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, 75012, Paris, France;State Key Laboratory for Infectious Disease Prevention and Control, and National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 102206, Beijing, China;Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, 310003, Hangzhou, China;The Institute of Microbiology, Chinese Academy of Sciences, 100101, Beijing, China;

关键词: Clostridium difficile;    NAP1/BI/027;    Outbreak;    Nosocomial infection;    Whole genome sequencing;   

DOI  :  10.1186/s12864-016-2708-0

 received in 2016-04-05, accepted in 2016-05-05,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe rapid spread of Clostridium difficile NAP1/BI/027 (C. difficile 027) has become one of the leading threats of healthcare-associated infections worldwide. However, C. difficile 027 infections have been rarely reported in Asia, particularly in China.ResultsIn this study, we identified a rare C. difficile bloodstream infection (BSI) from three isolates of a patient during repeated hospital admission. This finding triggered a retrospective epidemiological study to scan all cases and strains emerged from this ward during the past three years. Using medical personnel interviews, medical record reviews and the genomic epidemiology, two outbreaks in 2012 and 2013–2014 were identified. Through using whole genome sequencing, we succeeded to trace the origin of the BSI strain. Surprisingly, we found the genome sequences were similar to C. difficile 027 strain R20291, indicating the occurrence of a rare C. difficile 027 strain in China. Integrated epidemiological investigation and whole genome sequencing of all strains, we constructed a nosocomial transmission map of these two C. difficile 027 outbreaks and traced the origin of the infection.ConclusionsBy genome sequencing, spatio-temporal analysis and field epidemiology investigation, we can estimate their complex transform network and reveal the possible modes of transmission in this ward. Based on their genetic diversity, we can assume that the toilets, bathroom, and janitor’s equipment room may be contaminated area, which may be suggested to improve infection control measures in the following health care.

【 授权许可】

CC BY   
© Jia et al. 2016