Objective: To understand molecular characteristics and antibiotic resistance of Clostridioides (C.) difficile isolated from children in China, and provide data support the development of disease risk assessment and burden studies. Methods: A total of 155 strains of C. difficile isolated from children aged <12 years in 14 provinces (autonomous regions, municipalities) in China from 2010 to 2023 were used for the analyses on molecular characteristics and antibiotic resistance of C. difficile by PCR and drug susceptibility test. Results: A total of 26 sequence types (STs) and 18 ribotypes (RTs) were identified in the 155 C. difficile isolates, in which ST3 (20.65%), ST54 (16.13%), ST35 (12.90%), and RT012/ICDC007 (14.84%), RT001/ICDC001 (11.61%), RT046/ICDC018 (8.39%) were the most common. One highly virulent strain with RT078 and 27 non-toxin-producing strains were also found; the predominant toxin gene was tcdA+tcdB+cdt-. All the strains were sensitive to metronidazole and vancomycin, and there were 29 multidrug-resistant strains, in which 1 strain was resistant to all the seven antibiotics except for vancomycin and metronidazole. Conclusions: Molecular characteristics and antibiotic resistance of C. difficile in children were similar to those in whole population in China, but there were regional distribution differences. It is necessary to strengthen the routine drug-resistance surveillance for C. difficile infection in children in China.
目的： 了解我国儿童感染艰难梭菌的分子型别和耐药特征，为开展疾病风险评估和疾病负担研究提供支持。 方法： 利用2010-2023年从我国14个省（自治区、直辖市）收集的155株<12岁儿童来源的艰难梭菌菌株，采用菌株分离培养鉴定、PCR检测和药敏实验等方法，分析其分子型别和耐药特征。 结果： 155株艰难梭菌中鉴定出26个序列型（ST）和18个核糖体分型（RT），其中ST主要型别有ST3型（20.65%）、ST54型（16.13%）、ST35型（12.90%）；RT主要型别有RT012/ICDC007型（14.84%）、RT001/ICDC001型（11.61%）、RT046/ICDC018型（8.39%）。同时发现1株高毒力菌株RT078和27株非产毒菌株；毒素基因以tcdA+tcdB+cdt-菌株为主；所有菌株对甲硝唑和万古霉素敏感，多重耐药菌株有29株，其中1株菌株对除万古霉素和甲硝唑以外的其他7种抗生素均有耐药性。 结论： 我国儿童艰难梭菌的分子型别和耐药特征与我国全人群情况基本一致，但存在地区分布差异。应加强对我国儿童艰难梭菌感染的常规耐药监测。.