2023 Volume 38 Issue 3 Pages 90-98
The prevalence of Clostridioides difficile PCR-ribotype 027 (RT027) is low in Japan. We report an outbreak caused by RT027 that took place in a regional core hospital in Japan. From February to June in 2019, there were 18 new patients with C. difficile infection (CDI) in ward A. The peak of the outbreak was in March when the CDI incidence was 69.9/10,000 patient-days. Of the 18 CDI patients in ward A, specimens from 12 episodes on 11 patients were available for the analysis, and all 12 isolates were identified as RT027. Since RT027 was not recovered from any CDI patients from other wards, it was suggested that the outbreak was confined to the single ward. By thoroughly implementing basic infection control, the incidence of CDI in ward A decreased, and RT027 has not been recovered since July 2019. All 12 RT027 isolates were susceptible to moxifloxacin and gatifloxacin, suggesting that RT027 strain responsible for the outbreak represents the pre-epidemic RT027 genetic background from which the epidemic RT027 lineages emerged. Further studies are needed to clarify the epidemiology and clinical significance of RT027 C. difficile in Japan.
