Clostridioides (Clostridium) difficile in children with diarrhoea in Vietnam

Edith Cowan University, Edith Cowan University, Research Online, Perth, Western Australia, Perth, Western Australia 2022-04-01T07:00:00Z

Khun, Peng An
Phi, Long Duc
Pham, Phuong Thi
Nguyen, Ha Thi Thu
Vu, Quyen Thi Huyen
Collins, Deirdre A.
Riley, Thomas

Background: Clostridioides (Clostridium) difficile commonly causes hospital-acquired infection which can range from mild diarrhoea to life-threatening toxic megacolon and even death. Reports on C. difficile infection (CDI) in Vietnam are limited, so this study was designed to evaluate the prevalence, molecular epidemiology and antimicrobial susceptibility of C. difficile isolated from children with diarrhoea in Vietnam. Infants are often colonised with C. difficile and it was hypothesised that those colonising strains would represent strains of C. difficile circulating in the hospital/region at the time, however, this was not an attempt to determine if C. difficile was the cause of the diarrhoea. Methods: Diarrhoeal stool samples collected at two children's hospitals in northern Vietnam from October 1, 2020 to February 28, 2021 were transported to Perth, Western Australia, for culture of C. difficile and further investigations on isolates; PCR ribotyping, toxin gene profiling and antimicrobial susceptibility testing. Results: From these hospitals, 370 diarrhoeal stool samples were collected, most from children aged 1–15 months (71.9%; 266/370). The overall prevalence of C. difficile in stool samples from children aged ≤16 years was 37.8% (140/370) and the highest prevalence was in the 2–12 months age group (52.9%; 74/140). In total, 151 isolates of C. difficile were recovered; the proportion of toxigenic isolates was 16.6% (25/151). Of the 25 toxigenic C. difficile isolates, the toxin gene profiles A+B+CDT− and A−B+CDT− comprised 72% and 28%, respectively. The four most prevalent C. difficile ribotypes (RTs) were QX 011 (25/151), RT 010 (25/151), QX 107 (12/151) and RT 012 (11/151). All isolates were susceptible to vancomycin, metronidazole and fidaxomicin, while there was significant resistance to clindamycin (90.1%), and some to moxifloxacin (6.6%) and rifaximin (3.3%). Conclusion: The prevalence of C. difficile in children with diarrhoea was high (37.8%) although

Antimicrobial resistance; C. difficile; Children; PCR ribotype; Toxin gene profile; Vietnam; Medicine and Health Sciences; Public Health; text

Research outputs 2022 to 2026

ER0 oai:ro.ecu.edu.au:ecuworks2022-2026-1846
https://ro.ecu.edu.au/ecuworks2022-2026/846
https://doi.org/10.1016/j.anaerobe.2022.102550
1342693725

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