Epidemiology of Clostridium difficile infection in Asia
1 Microbiology and Immunology, School of Pathology and Laboratory Medicine, the University of Western Australia, Perth, Australia
2 West Midlands Public Health Laboratory, Health Protection Agency, Heart of England NHS Foundation Trust, Birmingham, UK
3 School of Immunity and Infection, University of Birmingham, Birmingham, UK
4 Division of Microbiology and Infectious Diseases, PathWest Laboratory Medicine (WA), Perth, Australia
Antimicrobial Resistance and Infection Control 2013, 2:21 doi:10.1186/2047-2994-2-21Published: 1 July 2013
While Clostridium difficile infection (CDI) has come to prominence as major epidemics have occurred in North America and Europe over the recent decade, awareness and surveillance of CDI in Asia have remained poor. Limited studies performed throughout Asia indicate that CDI is also a significant nosocomial pathogen in this region, but the true prevalence of CDI remains unknown. A lack of regulated antibiotic use in many Asian countries suggests that the prevalence of CDI may be comparatively high. Molecular studies indicate that ribotypes 027 and 078, which have caused significant outbreaks in other regions of the world, are rare in Asia. However, variant toxin A-negative/toxin B-positive strains of ribotype 017 have caused epidemics across several Asian countries. Ribotype smz/018 has caused widespread disease across Japan over the last decade and more recently emerged in Korea. This review summarises current knowledge on CDI in Asian countries.