Molecular epidemiology of infection (CDI) has been extensively studied in North America and Europe; however, limited data on CDI are available in the Asia-Pacific region. A multicentre retrospective study was conducted in this region. isolates were subjected to multilocus sequence typing (ST) and antimicrobial susceptibility testing. Totally, 394 isolates were collected from Hangzhou, Hong Kong, China; Busan, South Korea; Fukuoka, Japan; Singapore; Perth, Sydney, Australia; New York, the United States. isolates included 337 toxin A-positive/B-positive/binary toxin-negative (ABCDT), 48 ABCDT, and nine ABCDT. Distribution of dominant STs varied geographically with ST17 in Fukuoka (18.6%), Busan (56.0%), ST2 in Sydney (20.4%), Perth (25.8%). The antimicrobial resistance patterns were significantly different among the eight sites ( = 325.64, < 0.001). Five major clonal complexes correlated with unique antimicrobial resistances. Healthcare-associated (HA) CDI was mainly from older patients with more frequent antimicrobial use and higher AB positive rates. Higher resistance to gatifloxacin, tetracycline, and erythromycin were observed in HA-CDI patients ( = 4.76-7.89, = 0.005-0.029). In conclusion, multiple genotypes with varied antimicrobial resistance patterns have been circulating in the Asia-Pacific region. AB isolates from older patients with prior antimicrobial use were correlated with HA-CDI.
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| http://dx.doi.org/10.1080/22221751.2019.1682472 | DOI Listing |
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