| Kun-Ho Seo | 3 Articles |
<sec><b>Objectives</b><p>Studies on <italic>Clostridium difficile</italic> are rare in Korea. We investigated the epidemiological characteristics of <italic>C. difficile</italic> isolates from patients with <italic>C. difficile</italic>-associated disease (CDAD) in Korea.</p></sec><sec><b>Methods</b><p>Multiplex polymerase chain reaction was performed to detect the presence of <italic>tcdA</italic> and <italic>tcdB</italic> toxin genes. Antimicrobial susceptibility test was carried out by the disk-dilution method. <italic>C. difficile</italic> strains were subtyped by automated repetitive-element palindromic PCR (rep-PCR).</p></sec><sec><b>Results</b><p>Among patients with CDAD, 73 (25.8%), 32 (11.3%), 32 (11.3%), and 26 (9.2%) suffered from pneumonia, cancer or neoplasm, diabetes, and colitis, respectively. Of all stool samples, 43 samples (15.2%) were positive for <italic>C. difficile</italic> strains. We observed two expression patterns of toxin genes: <italic>tcdA</italic>+/<italic>tcdB</italic>+ (86% isolates) and <italic>tcdA</italic>−/<italic>tcdB</italic>+ (14% isolates), with all isolates expressing <italic>tcdB</italic>. Furthermore, some isolates were resistant to clindamycin (65%), ampicillin (56%), and cefazolin (40%), but all were susceptible to vancomycin and metronidazole. The tested samples were classified into diverse clusters using automated rep-PCR.</p></sec><sec><b>Conclusion</b><p>Our findings revealed the characteristics and antibiotic resistance of <italic>C. difficile</italic> isolates from patients in Korea. The epidemiological data may provide valuable insight into development of treatment strategies for <italic>C. difficile</italic> infections in Korea.</p></sec>
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<b>Purpose</b><br/>
To evaluate the abilities of these subtyping methods, we distinguished <i>Salmonella</i> Enteritidis (<i>S</i>. Enteritidis) isolated from food products and human clinical samples between 2009 and 2010 in Seoul using five subtyping methods.<br/><b>Methods</b><br/>
We determined the subtypes of 20 <i>S</i>. Enteritidis isolates from food and human sources using phage typing, antimicrobial susceptibility, pulsed-field gel electrophoresis (PFGE), repetitive sequence-based PCR (rep-PCR), and multi-locus sequence typing (MLST).<br/><b>Results</b><br/>
A total of 20 tested isolates were differentiated into six antimicrobial susceptibility patterns, three different phage types, four different PFGE profiles, seven rep-PCR patterns, and one MLST type. Food isolates were considerably more susceptible to antibiotics than human isolates. We were best able to discriminate among <i>S</i>. Enteritidis isolates using rep-PCR, and obtained the highest Simpson’s diversity index of 0.82, whereas other methods produced indices that were less than 0.71. PFGE pattern appeared to be more related to antimicrobial resistance and phage types of <i>S</i>. Enteritidis isolates than rep-PCR. MLST revealed identical alleles in all isolates at all seven loci examined, indicating no resolution.<br/><b>Conclusion</b><br/>
The results of this study suggest that rep-PCR provided the best discriminatory power for phenotypically similar <i>S</i>. Enteritidis isolates of food and human origins, whereas the discriminatory ability of MLST may be problematic because of the high sequence conservation of the targeted genes.
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