Toxinotype of Clostridium difficile in Taiwan

DOI: 10.6525/TEB.20151208.31(23).003

Hsiao-Lun Wei, Sin-Jie Lee, Jung-Jung Mu

2015 Vol.31 NO.23

Correspondence Author: Hsiao-Lun Wei

  • Center for Research, Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taiwan


Clostridium difficile is a pathogen highly associated with nosocomial infection; it causes diseases ranging from self-limited diarrhea to pseudomembranous colitis. Recently, the hyper-virulent strain of C. difficilehas appeared in Taiwan. In addition, a C.difficile nosocomial outbreak was reported at one southern hospital. In this study, 59 strains of toxigenic C.difficile with known PCR-ribotypes were collected during 2008–2009 from eight and two hospitals from central and southern Taiwan, and characterized by toxinotyping and Clostridium difficile binary toxin(CDT) detection. Of 59 strains, 48 strains produced A+B+ toxin, and 11 produced A–B+ toxin. Among A+B+ toxin producing strains, 46 strains were toxinotype 0, 1 strain was toxinotype VI, and 1 strain was new toxinotype (toxinotypeTN1). Among A–B+ toxin producing  strains, 6 strains were toxinotype VIII, 3 strains were toxinotype V-like, and 2 strains belonged to a new type(toxinotype  TN2). The strains of toxinotype 0 belonged to several PCR-riboytpes, whereas the strains of toxinotype VIII belonged to one PCR-ribotype, this indicated toxinotype VIII strains belonged to the same clonal origin. Six (10.2%) of 59 strains had CDT gene; among them, 2 strains were A+B+ toxin producing, 4 strains were A–B+ toxin producing. This study found that prevalence of A–B+ strains in Taiwan was similar to those in other Asian countries, but higher than those in Europe and USA. The strains of toxinotype V-like and VI in Taiwan was not reported in other Asian countries, neither the 2 new toxinotypes TN1 and TN2.

Keywords:Clostridium difficile;Toxinotype;PCR-ribotype;Clostridium difficile binary toxin