Predominance of PCR-ribotypes, 018 (smz) and 369 (trf) of Clostridium difficile in Japan: a potential relationship with other global circulating strains?

Global spread and evolutionary links of an epidemic Clostridium difficile strain (PCR-ribotype 027) have been noted in recent decades. However, in Japan, no outbreaks caused by type 027 have been reported to date. A total of 120 C. difficile isolates from patients at 15 hospitals during non-outbreak seasons between 2011 and 2013 as well as 18 and 21 isolates collected from two hospitals in 2010 and 2009, respectively, in outbreak periods in Japan, were examined. Among these 120 isolates, Japan-ribotypes smz and ysmz (subtype variant of smz) were the most predominant (39.2 %) followed by Japan-ribotype trf (15.8 %). Types smz/ysmz and trf were also concurrently predominant at two hospitals in the outbreak settings. Out of the five binary toxin-positive isolates observed, only one was PCR-ribotype 027 and another PCR-ribotype 078. Type smz was later found to correspond to PCR-ribotype 018. High rates of resistance against gatifloxacin, moxifloxacin, erythromycin and clindamycin were observed in the PCR-ribotype 018 isolates. Interestingly, all trf isolates were toxin A-negative, toxin B-positive, but they did not correspond to PCR-ribotype 017, thus being assigned a new ribotype (PCR-ribotype 369). In conclusion, PCR-ribotypes 018 (smz) and 369 (trf) were identified as major circulating strains in both outbreak and non-outbreak settings in Japan. Given their epidemiological relevance, molecular investigations are warranted to clarify potential evolutionary links with related strains found elsewhere, such as PCR-ribotypes 018 and 017 from Europe and North America.

Homologue and isomer distribution of dioxins observed in water samples collected from Kahokugata Lagoon and inflowing rivers, Japan.

Water samples were collected at 17 sites in Kahokugata Water Basin, a closed water basin in central Japan. We determined the concentration of dioxins of the water samples. Linear relationships between toxic equivalent (TEQ) concentrations of dioxin and concentrations of suspended solid (SS) were obtained at sites in Kahokugata Lagoon and in the rivers flowing into the lagoon. Homologue composition of polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (PCDFs) indicated that all the water samples were still strongly influenced by chlorinated herbicides, such as chloronitrofen (CNP) and pentachlorophenol (PCP) that had been widely used in rice fields. The main isomer distributions of the PCDD homologues were not significantly different among the sampling sites, while the main isomer distributions of the PCDF homologues were considerably different among the sampling sites. At a few sampling points in the downstream part of one of the rivers, high concentrations of 1,3,6,7,8-pentachloro dibenzofuran (1,3,6,7,8-PeCDF) and its related isomers (1,3,6,8-chlorine-substituted PCDFs) were traced to a dye manufacturing plant. These non-toxic isomers are usually only minor constituents in environmental water samples and are not indicators of any known dioxin sources. The dyeing discharge was found to make a contribution only in the water samples collected near the plant and the seasonal variation of the contribution might depend on the flow rate of the river.