1277. Epidemiologic Trends in Clostridium difficile Isolate Ribotypes in United States from 2010-2014
Session: Poster Abstract Session: HAI: C. difficile Epidemiology, Impact, and Testing
Friday, October 6, 2017
Room: Poster Hall CD
Posters
  • 1277 - Epidemiologic trends in C Diff ID Week Poster 2017.pdf (185.7 kB)
  • Background: Trends in the distribution of ribotypes for C. difficile associated diarrheal isolates obtained over time in the United States are lacking. As part of surveillance program for C. difficile susceptibility, we analyzed stool isolates for ribotype distribution from a phase 2 trial of surotomycin (2010-2011) (North America sites) as well as a national surveillance study from 2011-2014. Isolates for the surveillance study were referred from 6 geographically distinct medical centers.

    Methods: C. difficile isolates or C. difficile toxin + stools from patients with C. difficile associated diarrhea (CDAD) were submitted for testing to Tufts Medical Center. Following isolation and confirmation as C. difficile, a random sample of isolates were ribotyped by PCR capillary gel electrophoresis.

    Results: 673 isolates over the 5 years of the analysis have been ribotyped to date. There were 49 unique ribotype designations, and 16 ribotypes had more than 10 isolates. The ribotype distribution by year is shown in the table.

    Conclusion: There has been a change in the frequency of ribotypes over time in the US. Of the most common ribotypes seen, 027 has decreased by over 50% while there has been an increase of 014-020, 002, and 106. 014-020 is now the most common ribotype seen in the US. These data suggest that there is a changing epidemiology of C. difficile in the US and continuous monitoring of the ribotype distributions and clinical implications is warranted.

    Phase 2

    2011

    2012

    2013

    2014

    Total

    n=

    76

    135

    169

    141

    152

    673

    Ribotype

    % ribotype per year for isolates ≥10 isolates in a ribotype

    027

    43.4

    35.6

    23.7

    17.0

    13.8

    166

    014-020

    11.8

    11.1

    16.0

    9.9

    19.1

    94

    106

    6.6

    15.6

    12.4

    12.8

    11.2

    82

    002

    6.6

    5.2

    4.1

    9.2

    12.5

    51

    001

    1.3

    2.2

    3.6

    5.7

    1.3

    20

    053-163

    1.3

    4.4

    2.4

    3.5

    2.0

    19

    469

    1.3

    0.0

    2.4

    6.4

    2.0

    17

    078-126

    2.6

    2.2

    2.4

    2.1

    3.3

    17

    054

    1.3

    1.5

    3.6

    1.4

    3.3

    16

    017

    3.9

    1.5

    1.8

    0.7

    3.9

    15

    255

    2.6

    0.7

    1.8

    3.5

    2.6

    15

    012

    2.6

    2.2

    0.6

    4.3

    1.3

    14

    103

    2.6

    1.5

    3.0

    0.7

    2.6

    14

    485

    0.0

    1.5

    0.6

    5.0

    1.3

    12

    005

    1.3

    2.2

    0.6

    4.3

    0.7

    12

    056

    1.3

    2.2

    1.8

    0.0

    2.6

    11

    Others*

    9.2

    10.3

    19.5

    13.4

    16.4

    98

    *There were 33 ribotypes with less than 10 isolates

    David R Snydman, MD1, Laura A McDermott, MT(ASCP)1, Stephen G Jenkins, PhD2, Ellie J C Goldstein, MD, FIDSA, FSHEA3, Robin Patel, MD, FIDSA, D(ABMM)4, Betty A Forbes, Ph.D, D(ABMM), F(AAM)5, Stuart Johnson, MD, FIDSA6, Dale N Gerding, MD, FIDSA6, Cheleste M. Thorpe, MD1 and Seth T Walk, PhD7, (1)Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA, (2)NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, (3)RM Alden Research Laboratory, Santa Monica, CA, (4)Divisions of Clinical Microbiology and Infectious Diseases, Mayo Clinic, Rochester, MN, (5)Pathology & Medicine, Virginia Commonwealth University Medical Center, Richmond, VA, (6)Loyola University, Hines, IL, (7)Microbiology & Immunology, Montana State University, Bozeman, MT

    Disclosures:

    D. R. Snydman, Merck: Consultant and Grant Investigator , Consulting fee and Research grant
    Shire: Consultant , Consulting fee
    Summit PLC: Consultant and Grant Investigator , Consulting fee and Research grant
    BioK+: Consultant , Consulting fee
    Actelion: Grant Investigator , Research grant

    L. A. McDermott, None

    S. G. Jenkins, Cormedix: Consultant , Consulting fee
    Bayer: Consultant , Consulting fee
    Merck: Grant Investigator and Scientific Advisor , Research grant

    E. J. C. Goldstein, Merck: Grant Investigator , Scientific Advisor and Speaker's Bureau , Consulting fee and Grant recipient
    Cubist: Grant Investigator , Scientific Advisor and Speaker's Bureau , Consulting fee
    Actelion: Grant Investigator , Grant recipient
    Summit PLC: Grant Investigator and Scientific Advisor , Grant recipient

    R. Patel, Curetis: Consultant , Grant Investigator and Speaker's Bureau , Consulting fee and Research grant
    Pocared: Grant Investigator , Research grant
    nanoMR: Grant Investigator , Research grant
    BioFire: Grant Investigator , Research grant
    Check-Points: Grant Investigator , Research grant
    3M: Grant Investigator , Research grant
    Cubist: Grant Investigator , Research grant
    Merck: Grant Investigator , Research grant

    B. A. Forbes, None

    S. Johnson, Bio-K+: Consultant , Consulting fee

    D. N. Gerding, Merck, Shire, Cubist, Rebiotix, Sanofi Pasteur, Summit, DaVoltera, Actelion: Consultant , Consulting fee
    CDC, US Dept of Veterans Affairs Research Service: Grant Investigator , Research grant

    C. M. Thorpe, None

    S. T. Walk, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 4th with the exception of research findings presented at the IDWeek press conferences.