Author/Authors :
Jassem, Agatha n British Columbia Centre for Disease Control Public Health Laboratory, Canada , Prystajecky, Natalie British Columbia Centre for Disease Control Public Health Laboratory, Canada , Marra, Fawziah British Columbia Centre for Disease Control Public Health Laboratory, Canada , Kibsey, Pamela Island Health - Victoria, Canada , Tan, Kennard Island Health - Victoria, Canada , Umlandt, Patricia British Columbia Centre for Disease Control Public Health Laboratory, Canada , Janz, Loretta British Columbia Centre for Disease Control Public Health Laboratory, Canada , Champagne, Sylvie Providence Health Care, Vancouver, Canada , Gamage, Bruce Provincial Infection Control Network of British Columbia, Vancouver, BC, Canada V6H 4B1 , Golding, George R National Microbiology Laboratory - Winnipeg, canada , Mulvey, Michael R National Microbiology Laboratory - Winnipeg, Canada , Henry, Bonnie British Columbia Centre for Disease Control Public Health Laboratory, Canada , Hoang, Linda M. N British Columbia Centre for Disease Control Public Health Laboratory, Canada
Abstract :
Background. Clostridium difficile is a major cause of gastrointestinal illness. Epidemic NAP1 strains contain toxins A and B, a deletion in repressor tcdC, and a binary toxin. Objectives. To determine the molecular epidemiology of C. difficile in British Columbia and compare between two time points in one region. Methods. C. difficile isolates from hospital and community laboratories (2008) and one Island Health hospital laboratory (2013) were characterized by pulsed-field gel electrophoresis, PCR-ribotyping, toxin possession, tcdC genotype, and antimicrobial susceptibility. Results. In 2008, 42.7% of isolates had NAP1 designation. Hospital-collected isolates were associated with older patients and more NAP1 types. Unlike other isolates, most NAP1 isolates possessed binary toxin and a 19 bp loss in tcdC. All isolates were susceptible to metronidazole and vancomycin. A 2013 follow-up revealed a 28.9% decrease in NAP1 isolates and 20.0% increase in isolates without NAP designation in one region. Then, community-associated cases were seen in younger patients, while NAP types were evenly distributed. Isolates without NAP designation did not cluster with a PFGE pattern or ribotype. Conclusions. Evaluation of C. difficile infections within British Columbia revealed demographic associations, epidemiological shifts, and characteristics of strain types. Continuous surveillance of C. difficile will enable detection of emerging strains.
Keywords :
Characterization , Clostridium difficile Strains , British Columbia , NAP1 Majority , Novel Strain Types
