Title page for etd-0016114-153427


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URN etd-0016114-153427
Author Shu-Fang Kuo
Author's Email Address ivy.kuo@yahoo.com.tw
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Department Biological Sciences
Year 2013
Semester 1
Degree Master
Type of Document
Language zh-TW.Big5 Chinese
Title Molecular epidemiology of Clostridium difficile in southern Taiwan
Date of Defense 2013-12-11
Page Count 81
Keyword
  • binary toxin
  • multiplex PCR
  • C.difficile infection
  • Clostridium difficile associated diarrhea
  • Clostridium difficile
  • Abstract The incidence of Clostridium difficile associated diarrhea (CDAD) has been rising in recent years. There were CDAD regional outbreaks in North America and Europe during the years from 2003 to 2005. Genetic variations have been identified world-widely. They are closely related to high toxigenic strains and clinical pathogenesis. The epidemic strains of CDAD (C. difficile NAP1/B1/ 027), with its high toxigenic ability, results in an increasing mortality rate and has become a serious public health problem and draws great attention to medical profession. At present, C. difficile has become the main pathogens of nosocomial diarrhea. In this study, we attempted to characterize the epidemiological analysis of C. difficile strains during the years of 2008-2009 in a medical center of southern Taiwan, especially emphasized on the difference between nosocomial and community-acquired CDI. The multiplex PCR was used to detect the tcdA、tcdB and cdtA、cdtB, and deployed a gene sequencing method to detect tcdC mutation. We found that the number of CDI patients significantly increased for those over the age of 40, and the incidence increased from the age of 40 and peaked at the age of 80, and after that the number was gradually decreased. In terms of the usage of antibiotics, other concomitant microbial infections, death and fever, nosocomial-infected patients were all significantly higher than those of community-acquired. Furthermore, toxin genotype study indicated that there were equal amounts in toxigenic and non-toxigenic strains, however, the proportion infected by toxigenic strains was higher in community-acquired patients than in nosocomial-infection patients, and a higher proportion in community-acquired CDI patients were infected by binary toxin. All 32 strains that produced binary toxin had tcdC gene variations, including base pair deletion, insertion and mutation, and were in advance to produce the stop codon. Hopefully, the results of this molecular epidemiological study would be helpful for future prevention and control of the CDAD.
    Advisory Committee
  • Chung-Lung Cho - chair
  • Huey-Ling You - co-chair
  • Jong-Kang Liu - advisor
  • Hock-Liew Eng - advisor
  • Files
  • etd-0016114-153427.pdf
  • Indicate in-campus at 5 year and off-campus access at 5 year.
    Date of Submission 2014-01-16

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