Antimicrobial susceptibility and molecular typing of toxigenic clinical isolates of Clostridium difficile causing infections in the south of Spain

Arca-Suárez, Jorge; Galán-Sánchez, Fátima; Cano-Cano, Fátima; García-Santos, G.; Rodríguez-Iglesias, Manuel

doi:10.1016/j.anaerobe.2018.09.006

Cited by 7 publications

(3 citation statements)

References 31 publications

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“…Antibiotic susceptibility test results have shown that all 18 C. difficile isolates were susceptible to VAN and MTZ, the treatment of choice for CDI [57], as well as to MXF, a fourth generation fluoroquinolone [58], which is in line with the results of several other studies [59].…”

Section: Discussionsupporting

confidence: 86%

Molecular epidemiology and antimicrobial resistance patterns of Clostridioides difficile isolates in Algerian hospitals

Boudjelal

Krůtová

Djebbar

et al. 2022

J Infect Dev Ctries

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Introduction: Clostridioides difficile is a major pathogen responsible for hospital-associated diarrhoea. This study investigated the molecular epidemiology and antibiotic resistance of C. difficile isolates in five Algerian hospitals. Methodology: Between 2016 and 2019, faecal specimens were collected from in-patients and were cultured for C. difficile. Isolates were characterised by toxin genes detection, Polymerase Chain Reaction (PCR)-ribotyping, Multilocus Sequence Typing (MLST), antimicrobial susceptibility testing against a panel of antibiotics, and screened for antimicrobial resistance genes. Results: Out of 300 patient stools tested, 18 (6%) were positive for C. difficile by culture, and were found to belong to 11 different ribotypes (RT) and 12 sequence types (ST): RT 085/ST39, FR 248/ST259, FR 111/ST48, RT 017/ST37, RT 014/ST2, RT 014/ST14, FR 247/new ST, RT 005/ST6, RT 029/ST16, RT 039/ST26, RT 056/ST34 and RT 446/ST58. MLST analysis assigned the isolates to two clades, 1 and 4. Clade 4 was more homogeneous, as it mainly included non-toxigenic isolates. Three toxin gene profiles were detected, two toxigenic, A+B+CDT- (33.3%) and A-B+CDT- (11%); and one non-toxigenic, A-B-CDT- (55.5%). All C. difficile isolates were susceptible to metronidazole, vancomycin and moxifloxacin. Conclusions: Overall prevalence of C. difficile in our healthcare settings was 6%. Antibiotic resistance rates ranged from 72.2% (clindamycin) to 16.6% (tetracycline). This study highlighted a relatively high genetic diversity in term of ribotypes, sequence types, toxin and antibiotic resistance patterns, in the C. difficile isolates. Further larger studies are needed to assess the true extent of C. difficile infections in Algeria.

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Section: Discussionsupporting

confidence: 86%

Molecular epidemiology and antimicrobial resistance patterns of Clostridioides difficile isolates in Algerian hospitals

Boudjelal

Krůtová

Djebbar

et al. 2022

J Infect Dev Ctries

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“…This increase in resistance is contrary to European surveillance of isolates obtained from July 2011 to July 2014, where rates decreased from 7.2% to 2.2% over time (10). However, a recent single-center study from Spain reported that 20% of 70 isolates isolated from 2015 to 2016 were imipenem resistant (17). In this study, clindamycin resistance remained high (27.6%), but moxifloxacin resistance decreased over time from 33.5% in 2011 to 2012 to 20.7% in 2015 to 2016.…”

Section: Discussionmentioning

confidence: 70%

U.S.-Based National Surveillance for Fidaxomicin Susceptibility of Clostridioides difficile-Associated Diarrheal Isolates from 2013 to 2016

Thorpe

McDermott

Tran

et al. 2019

Antimicrob Agents Chemother

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In 2011, we initiated a sentinel surveillance network to assess changes in Clostridioides (formerly Clostridium) difficile antimicrobial susceptibility to fidaxomicin from 6 geographically dispersed medical centers in the United States. This report summarizes data from 2013 to 2016. C. difficile isolates or toxin-positive stools from patients were referred to a central laboratory. Antimicrobial susceptibility was determined by agar dilution. CLSI, EUCAST, or FDA breakpoints were used, where applicable. Toxin gene profiles were characterized by multiplex PCR on each isolate. A random sample of approximately 40% of isolates, stratified by institution and year, was typed by restriction endonuclease analysis (REA). Among 1,889 isolates from 2013 to 2016, the fidaxomicin MIC 90 was 0.5 g/ml; all isolates were inhibited at Յ1 g/ml. There were decreases in metronidazole and vancomycin MICs over time. Clindamycin resistance remained unchanged (27.3%). An increase in imipenem resistance was observed. By 2015 to 2016, moxifloxacin resistance decreased in all centers. The proportion of BI isolates decreased from 25.5% in 2011 to 2012 to 12.8% in 2015 to 2016 (P Ͻ 0.001). The BI REA group correlated with moxifloxacin resistance (BI 84% resistant versus non-BI 12.5% resistant). Fidaxomicin MICs have not changed among C. difficile isolates of U.S. origin over 5 years post licensure. There has been an overall decrease in MICs for vancomycin, metronidazole, moxifloxacin, and rifampin and an increase in isolates resistant to imipenem. Moxifloxacin resistance remained high among the BI REA group, but the proportion of BI isolates has decreased. Continued geographic variations in REA groups and antimicrobial resistance persist.

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“…[36][37][38][39] It is striking that most compounds show a lower MIC 90 against C. difficile than that observed with C. perfringens. This is an interesting feature, since C. difficile has high levels of resistance [62][63][64] to many antibacterial drugs (b-lactams including carbapenems, quinolones, clindamycin and rifampicin, among others) except for vancomycin and metronidazole, while C. perfringens remains susceptible to a large number of antimicrobials, including penicillin.…”

Section: Antimicrobial Activitymentioning

confidence: 99%

Amidinoquinoxaline N-oxides: synthesis and activity against anaerobic bacteria

Gruber,

Fernández-Canigia,

Kilimciler

et al. 2023

RSC Adv.

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Antimicrobial susceptibility and molecular typing of toxigenic clinical isolates of Clostridium difficile causing infections in the south of Spain

Cited by 7 publications

References 31 publications

Molecular epidemiology and antimicrobial resistance patterns of Clostridioides difficile isolates in Algerian hospitals

Molecular epidemiology and antimicrobial resistance patterns of Clostridioides difficile isolates in Algerian hospitals

U.S.-Based National Surveillance for Fidaxomicin Susceptibility of Clostridioides difficile-Associated Diarrheal Isolates from 2013 to 2016

Amidinoquinoxaline N-oxides: synthesis and activity against anaerobic bacteria

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