Background: C. difficile (CD) isolates from patients with hospital acquired CDI can be genetically very diverse. The purpose of this study was to determine the epidemiology and genetic diversity of all CD isolates from 3 medical centers in the greater New York area.
Methods: During 6 consecutive months, WMC, a tertiary care hospital, ORMC, a large community hospital that refers to WMC , and MSKCC a specialty cancer hospital, collected data for all hospitalized CDI patients, identified by a stool PCR test for C. difficile toxigenic B gene (Cepheid Inc.). Multilocus sequence typing (MLST) was performed on retrieved toxigenic strains of CD.
Results: The 3 sites varied significantly in patient age, percentages of cases within epidemiologic classifications, previous discharge, severe CDI, and contact precautions duration (Table). Number of MLST sequence types (ST) isolated were: 34 STs from 124 WMC isolates, 27 STs for 55 ORMC isolates, and 40 STs for 192 MSKCC isolates. The predominant STs were similar at WMC and ORMC and differed from MSKCC STs (Figures); MSKCC had significantly fewer ST 1 (NAP 1) isolates (9% vs 26% p=<0.001).
Conclusion: Diversity among CD ST was demonstrated for all 3 hospitals. The distribution of STs was similar for the 2 hospitals that transfer patients between them and differed from the cancer specialty hospital where NAP-1 ST and CDI complications were less frequent. . The STs will be used to further understand CDI transmission and the correlation between ST and epidemiologic definitions and CDI outcome.
D. Mckenna, None
J. Menz, None
L. Klimczak, None
M. Zolendjeski, None
G. Wang, None
G. Wormser, None
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