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Journal of Clinical Microbiology, April 2001, p. 1391-1395, Vol. 39, No. 4
Department of Bacteriology, School of Medicine, Kanazawa
University, Kanazawa 920-8640,1
Institute of Anaerobic Bacteriology, Gifu University School of
Medicine, Gifu 500-8705,2
Nagoyashi-Koseiin Geriatric Hospital, Nagoya
465-8610,3 Ogaki Municipal Hospital,
Ogaki 503-0864,4 and Yamaguchi
Prefectural Hospital, Bofu 747-8511,5 Japan,
and Nosocomial Pathogens Laboratory Branch, Hospital Infections
Program, National Center for Infectious Diseases, Centers for
Disease Control and Prevention, Atlanta, Georgia
303336
Received 21 September 2000/Returned for modification 29 December
2000/Accepted 6 February 2001
Clostridium difficile isolates recovered from patients
with C. difficile-associated diarrhea (CDAD) at three
hospitals located in diverse areas of Japan were analyzed by three
typing systems, PCR ribotyping, pulsed-field gel electrophoresis
(PFGE), and Western immunoblotting. At the three hospitals examined, a
single PCR ribotype strain (type smz) was predominant and accounted for
22 (65%) of 34, 18 (64%) of 28, and 11 (44%) of 25 isolates,
respectively. All of the 51 isolates that represented PCR ribotype smz
were nontypeable by PFGE because of DNA degradation. Since the type smz
strain did not react with any of the antisera against 10 different serogroups (A, B, C, D, F, G, H, I, K, and X), we prepared a new antiserum against a type smz isolate. All 51 type smz isolates presented identical banding patterns, reacting with the newly prepared
antiserum (designated subserogroup JP-0 of serogroup JP). These results
were compared with those of a strain from a hospital outbreak that
occurred in New York, which has been identified as type J9 by
restriction enzyme analysis and type 01/A by arbitrarily primed PCR but
was nontypeable by PFGE because of DNA degradation. This strain was
reported to be epidemic at multiple hospitals in the United States. The
J9 strain represented a PCR ribotype pattern different from that of a
type smz strain and was typed as subserogroup G-1 of serogroup
G by immunoblot analysis. A single outbreak type causing nosocomial
CDAD in Japan was found to be different from the strain causing
multiple outbreaks in the United States, even though the outbreak
strains from the two countries were nontypeable by PFGE because of DNA degradation.
0095-1137/01/$04.00+0 DOI: 10.1128/JCM.39.4.1391-1395.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Analysis of Clostridium difficile Isolates from
Nosocomial Outbreaks at Three Hospitals in Diverse Areas of
Japan
*
Corresponding author. Mailing address: Department of
Bacteriology, School of Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8640, Japan. Phone: 81-76-265-2202. Fax:
81-76-234-4230. E-mail: cato{at}med.kanazawa-u.ac.jp.
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