Molecular characterisation of Czech Clostridium difficile isolates collected in 2013–2015

Abstract

Clostridium difficile is a leading nosocomial pathogen and molecular typing is a crucial part of monitoring its occurrence and spread. Over a three-year period (2013)(2014)(2015), clinical Clostridium difficile isolates from 32 Czech hospitals were collected for molecular characterisation. Of 2,201 C. difficile isolates, 177 (8%) were non-toxigenic, 2,024 (92%) were toxigenic (tcdA and tcdB) and of these, 677 (33.5%) carried genes for binary toxin production (cdtA, cdtB). Capillary-electrophoresis (CE) ribotyping of the 2,201 isolates yielded 166 different CE-ribotyping profiles, of which 53 were represented by at least two isolates for each profile. Of these, 29 CE-ribotyping patterns were common to the Leeds-Leiden C. difficile reference strain library and the WEBRIBO database (83.7% isolates), and 24 patterns were recognized only by the WEBRIBO database (11.2% isolates). Isolates belonging to these 53 CE-ribotyping profiles comprised 94.9% of all isolates. The ten most frequent CE-ribotyping profiles were 176 (n=588, 26.7%), 001 (n=456, 20.7%), 014 (n=176, 8%), 012 (n=127, 5.8%), 017 (n=85, 3.9%), 020 (n=68, 3.1%), 596 (n=55, 2.5%), 002-like (n=45, 2.1%), 010 (n=35, 1.6%) and 078 (n=34, 1.6%). Multi-locus sequence typing (MLST) of seven housekeeping genes performed in one isolate of each of 53 different CE-ribotyping profiles revealed 40 different sequence types (STs). We conclude that molecular characterisation of Czech C. difficile isolates revealed a high diversity of CE-ribotyping profiles; the prevailing RTs were 001 (20.7%) and 176 (027-like, 26.7%).

Molecular, microbiological and clinical characterization of Clostridium difficile isolates from tertiary care hospitals in Colombia

“…In this study, all C . difficile isolates were susceptible to metronidazole and vancomycin, including the virulent ribotypes 027 and 001/0072 that in other studies have been associated with resistance to various antimicrobials [ 2 , 50 ]. Of note, 87.7% of the isolates were resistant to clindamycin and 7.7% to moxifloxacin, results that contrast with those from the Pan-European longitudinal surveillance of antibiotic study which reported resistance of 39.9% and 49.6% to moxifloxacin and clindamycin, respectively [ 50 ].…”

The Colonisation of Calves in Czech Large-Scale Dairy Farms by Clonally-Related Clostridioides difficile of the Sequence Type 11 Represented by Ribotypes 033 and 126

“…The C. difficile ribotypes 046 and 126 belong to ribotypes identified in stool samples from CDI hospitalised patients in the Czech Republic and Europe as well [ 18 , 38 ]. The role of the C. difficile ribotype 033 in human CDI still remains unclear due to the absence of toxins A/B [ 8 , 16 ].…”

Epidemiologie infekcí vyvolaných Clostridium difficile (CDI) v České republice

“…Na současné epidemiologické situaci CDI v ČR se podílí rozšíření dvou ribotypů Clostridium difficile, ribotypu 001 a 176 (14) izolátů Clostridium difficile, která byla pozorována v jednotlivých nemocničních zařízeních tak i mezi nimi, což potvrzuje vyšší potenciál těchto ribotypů k šíření v nemocničním prostředí (6). Ačkoliv výše zmíněné ribotypy (001 a 176) dominující epidemiologické situaci v ČR jsou fylogeneticky odlišné (14) , jejich společným epidemiologickým znakem je popsaná rezistence hned k několika antimikrobním přípravkům a s tím spojená kumulace mechanismů rezistence (15). S výskytem výše zmíněných Clostridium difficile ribotypů (001 a 176) v ČR bylo analýzou 490 CDI epizod z 28 českých nemocnic signifikantně asociováno předchozí podávání fluorochinolonů (7).…”