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However, little is known about CDI in Mainland China. In this study, we aimed to investigate the incidence of CDI and the main epidemic and drug-resistant strains of\n                    <jats:italic>C. difficile<\/jats:italic>\n                    in Mainland China through meta-analysis of related studies published after the year 2010. A total of 51 eligible studies were included. The pooled incidence of toxigenic\n                    <jats:italic>C. difficile<\/jats:italic>\n                    among patients with diarrhoea was 14% (95% CI\u2009=\u200912\u201316%). In Mainland China, ST-37 and ST-3 were the most prevalent strains; fortunately, hypervirulent strains, such as ST-1 (BI\/NAP1\/027) and ST-11 (RT 078), have only occurred sporadically to date. The rates of\n                    <jats:italic>C. difficile<\/jats:italic>\n                    resistance to ciprofloxacin (98.3%; 95% CI\u2009=\u200996.9\u201399.7%), clindamycin (81.7%; 95% CI\u2009=\u200976.1\u201387.3%) and erythromycin (80.2%; 95% CI\u2009=\u200973.5\u201386.9%) are higher than in other counties; however, none of the\n                    <jats:italic>C. difficile<\/jats:italic>\n                    isolates reported in Mainland China were resistant to metronidazole (n\/N\u2009=\u20090\/960), vancomycin (n\/N\u2009=\u20090\/960), tigecycline (n\/N\u2009=\u20090\/41) or piperacillin\/tazobactam(n\/N\u2009=\u20090\/288).\n                  <\/jats:p>","DOI":"10.1038\/srep37865","type":"journal-article","created":{"date-parts":[[2016,11,29]],"date-time":"2016-11-29T05:57:45Z","timestamp":1480399065000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":61,"title":["The incidence and drug resistance of Clostridium difficile infection in Mainland China: a systematic review and meta-analysis"],"prefix":"10.1038","volume":"6","author":[{"given":"Chenjie","family":"Tang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lunbiao","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqiao","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengfei","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengcheng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenying","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genyan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2016,11,29]]},"reference":[{"key":"BFsrep37865_CR1","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1056\/NEJM197803092981003","volume":"298","author":"JG Bartlett","year":"1978","unstructured":"Bartlett, J. 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