2073. Prevalence of Clostridium difficile ribotypes in Minnesota, 2012-2014
Session: Poster Abstract Session: Clostridium difficile: Epidemiology
Saturday, October 29, 2016
Room: Poster Hall
  • PrevalencePoster_Final.pdf (303.5 kB)
  • Background: Clostridium difficile infections (CDI) are the leading cause of healthcare-associated diarrhea and colitis. PCR ribotyping has been used to describe the molecular epidemiology of CDI. Ribotype (RT) 027 has historically predominated nationally and RT 078 has been associated with animal exposure. We describe the RTs circulating in Minnesota (MN) from 2012–2014.

    Methods: The MN Department of Health performs active, population and laboratory based surveillance for CDI as part of the CDC’s Emerging Infections Program. C. difficile positive stool specimens were sent to the MN Public Health Laboratory for culture. Recovered isolates were randomly forwarded to CDC for molecular characterization and PCR ribotyping. Cases were defined as community-associated (CA) if stool was collected as an outpatient, or as an inpatient ≤3 days of admission with no overnight stay in a healthcare facility 12 weeks prior; remaining cases were defined as healthcare-associated (HA). Medical records were reviewed and CA cases were interviewed to assess healthcare exposures, medications and animal exposures.

    Results: Of 1474 C. difficile isolates, 754 (51%) were characterized; 103 unique RTs were recovered. The most prevalent RTs were 106 (79, 10%), 002 (70, 9%), 020 (69, 9%), 014 (52, 7%), and 027 (50, 7%). Of 1,120 CA cases, 37% were ribotyped; predominant strains were 020 (44, 11%), 106 (41, 10%), 002 (36, 9%), 014 (30, 7%), and 027 (22, 5%). Of 855 HA cases, 40% were ribotyped; predominant strains were 106 (38, 11%), 002 (34, 10%), 027 (28, 8%), 020 (25, 7%), and 014 (22, 7%). The predominant RTs did not change significantly over the study time period and no difference in predominant RTs was detected when comparing healthcare exposure in the 12 weeks prior to infection. Of the 19 RT 078 isolates identified from CA cases, 2 (11%) reported exposure to agricultural animals.

    Conclusion: A diverse population of RTs were found in MN with no single RT accounting for >10% of circulating RTs in total and over time. RT 106 rather than 027 predominated and few 078 were detected limiting the ability to identify potential risk factors. Continued characterization of RTs and linkage with epidemiologic data is needed to monitor changes in circulating strains and determine RT specific risk factors.

    Dominic Sandmeier Jr., BS1, Tory Whitten, MPH1, Maria S. Karlsson, PhD2 and Stacy Holzbauer, DVM, MPH, DACVPM1,3, (1)Infectious Disease Epidemiology, Prevention, and Control Division, Minnesota Department of Health, St. Paul, MN, (2)Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, (3)Division of State and Local Readiness, Centers for Disease Control and Prevention, Atlanta, GA


    D. Sandmeier Jr., None

    T. Whitten, None

    M. S. Karlsson, None

    S. Holzbauer, None

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