单位：[1]Department of clinical laboratory, China-Japan Friendship Hospital, No. 2 Yinghua Dongjie, Chaoyang, Beijing 100029, China.[2]Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, and Beijing Key Laboratory of Emerging infectious Diseases, No. 8 Jingshundongjie, Beijing 100015, China.[3]State Key Laboratory for Infectious Disease Prevention and Control, and National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.[4]Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping, Beijing 102206, China.[5]National Reference Laboratory for Clostridium difficile, Faculté de Médecine Pierre et Marie Curie and Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris 75012, France.[6]Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou 310003, China.[7]The Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China.
Background: The rapid spread of Clostridium difficile NAP1/BI/027 (C. difficile 027) has become one of the leading threats of healthcare-associated infections worldwide. However, C. difficile 027 infections have been rarely reported in Asia, particularly in China. Results: In this study, we identified a rare C. difficile bloodstream infection (BSI) from three isolates of a patient during repeated hospital admission. This finding triggered a retrospective epidemiological study to scan all cases and strains emerged from this ward during the past three years. Using medical personnel interviews, medical record reviews and the genomic epidemiology, two outbreaks in 2012 and 2013-2014 were identified. Through using whole genome sequencing, we succeeded to trace the origin of the BSI strain. Surprisingly, we found the genome sequences were similar to C. difficile 027 strain R20291, indicating the occurrence of a rare C. difficile 027 strain in China. Integrated epidemiological investigation and whole genome sequencing of all strains, we constructed a nosocomial transmission map of these two C. difficile 027 outbreaks and traced the origin of the infection. Conclusions: By genome sequencing, spatio-temporal analysis and field epidemiology investigation, we can estimate their complex transform network and reveal the possible modes of transmission in this ward. Based on their genetic diversity, we can assume that the toilets, bathroom, and janitor's equipment room may be contaminated area, which may be suggested to improve infection control measures in the following health care.
基金：
National High Technology Research and Development Program ("863" Program)National High Technology Research and Development Program of China [2014AA021505, 2011AA02A109]; National Key Technology RD ProgramNational Key Technology R&D Program [2012BAH24F05]; National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [81201322, 81301402]; NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISMUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Alcohol Abuse & Alcoholism (NIAAA) [R01AA021505] Funding Source: NIH RePORTER
通讯机构：[2]Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, and Beijing Key Laboratory of Emerging infectious Diseases, No. 8 Jingshundongjie, Beijing 100015, China.[3]State Key Laboratory for Infectious Disease Prevention and Control, and National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
推荐引用方式(GB/T 7714)：
Hongbing Jia,Pengcheng Du,Hui Yang,et al.Nosocomial transmission of Clostridium difficile ribotype 027 in a Chinese hospital, 2012-2014, traced by whole genome sequencing[J].BMC GENOMICS.2016,17:doi:10.1186/s12864-016-2708-0.
APA：
Hongbing Jia,Pengcheng Du,Hui Yang,Yuanyuan Zhang,Jing Wang...&Chen Chen.(2016).Nosocomial transmission of Clostridium difficile ribotype 027 in a Chinese hospital, 2012-2014, traced by whole genome sequencing.BMC GENOMICS,17,
MLA：
Hongbing Jia,et al."Nosocomial transmission of Clostridium difficile ribotype 027 in a Chinese hospital, 2012-2014, traced by whole genome sequencing".BMC GENOMICS 17.(2016)
