Prevalence, genetic relatedness and antibiotic resistance of hospital-acquired clostridium difficile PCR ribotype 018 strains

Seo, Minah; Kim, Jieun; Lee, Yangsoon; Lim, Dhongil; Pai, Hyunjoo

doi:10.1016/j.ijantimicag.2018.01.025

Cited by 12 publications

(5 citation statements)

References 25 publications

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“…Sydney and Perth, two major cities in Australia, had the same dominant genotype, ST2. Similar data has been reported previously [12,18]. In addition, different sites had their own dominant genotypes, i.e.…”

Section: Discussionsupporting

confidence: 89%

“…In Japan, ST17, which includes the closely related RTs smz/RT018 and smz′/QX239, was the dominant genotype, followed by RT014/ST2, RT002/ST8, and RT369/ST81 [12,14]. ST17 was also the predominant genotype in South Korea, showing high resistance to clindamycin and moxifloxacin [12,18]. However, in general, the molecular characteristics and antimicrobial resistances of C. difficile strains circulating in patients with CDI in the Asia-Pacific region have not been well-described, and differences between HA- and CA-CDI in the Asia-Pacific region are still unclear.…”

Section: Introductionmentioning

confidence: 99%

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Different molecular characteristics and antimicrobial resistance profiles of Clostridium difficile in the Asia-Pacific region

Luo

Cheong

Bian

et al. 2019

Emerging Microbes & Infections

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Molecular epidemiology of Clostridium difficile infection (CDI) has been extensively studied in North America and Europe; however, limited data on CDI are available in the Asia-Pacific region. A multicentre retrospective study was conducted in this region. C. difficile isolates were subjected to multilocus sequence typing (ST) and antimicrobial susceptibility testing. Totally, 394 isolates were collected from Hangzhou, Hong Kong, China; Busan, South Korea; Fukuoka, Japan; Singapore; Perth, Sydney, Australia; New York, the United States. C. difficile isolates included 337 toxin A-positive/B-positive/binary toxin-negative (A+B+CDT-), 48 A-B+CDT-, and nine A+B+CDT+. Distribution of dominant STs varied geographically with ST17 in Fukuoka (18.6%), Busan (56.0%), ST2 in Sydney (20.4%), Perth (25.8%). The antimicrobial resistance patterns were significantly different among the eight sites (χ2 = 325.64, p < 0.001). Five major clonal complexes correlated with unique antimicrobial resistances. Healthcare-associated (HA) CDI was mainly from older patients with more frequent antimicrobial use and higher A-B+ positive rates. Higher resistance to gatifloxacin, tetracycline, and erythromycin were observed in HA-CDI patients (χ2 = 4.76-7.89, p = 0.005-0.029). In conclusion, multiple C. difficile genotypes with varied antimicrobial resistance patterns have been circulating in the Asia-Pacific region. A-B+ isolates from older patients with prior antimicrobial use were correlated with HA-CDI.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Different molecular characteristics and antimicrobial resistance profiles of Clostridium difficile in the Asia-Pacific region

Luo

Cheong

Bian

et al. 2019

Emerging Microbes & Infections

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“…A closely related strain, “smz’”/QX 239/ST17 is now also circulating at high prevalence in Japan [59,60]. RT 018 is now the most common C. difficile strain reported from Korea, where it has largely replaced RT 017 [23,74]. RT 012/ST54 and RT 046/ST35 localise to China in particular [75,76,77,78,79], RT 014/020/ST2/14 is widespread across the continent [31], and RT 002/ST8 is most frequently reported from Taiwan and Hong Kong [31,80].…”

Section: Epidemiology Of CDI In Asiamentioning

confidence: 99%

Clostridium difficile in Asia: Opportunities for One Health Management

Collins

Riley

2018

TropicalMed

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Clostridium difficile is a ubiquitous spore-forming bacterium which causes toxin-mediated diarrhoea and colitis in people whose gut microflora has been depleted by antimicrobial use, so it is a predominantly healthcare-associated disease. However, there are many One Health implications to C. difficile, given high colonisation rates in food production animals, contamination of outdoor environments by use of contaminated animal manure, increasing incidence of community-associated C. difficile infection (CDI), and demonstration of clonal groups of C. difficile shared between human clinical cases and food animals. In Asia, the epidemiology of CDI is not well understood given poor testing practices in many countries. The growing middle-class populations of Asia are presenting increasing demands for meat, thus production farming, particularly of pigs, chicken and cattle, is rapidly expanding in Asian countries. Few reports on C. difficile colonisation among production animals in Asia exist, but those that do show high prevalence rates, and possible importation of European strains of C. difficile like ribotype 078. This review summarises our current understanding of the One Health aspects of the epidemiology of CDI in Asia.

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“…Although metronidazole and vancomycin are the current choices for treatment of mild-to-moderate CDI and severe infection, susceptibility to these antibiotics has been gradually decreasing [ 13 , 36 , 37 ]. In a study conducted in Israel, the susceptibility to metronidazole and vancomycin among ribotype 027 was 44.6% and 87.7%, respectively [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Phenotypical and Genotypical Comparison of Clostridium difficile Isolated from Clinical Samples: Homebrew DNA Fingerprinting versus Antibiotic Susceptibility Testing (AST) and Clostridial Toxin Genes

Sisakhtpour

Moghadam

Khodaparast

et al. 2021

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Background. Clostridium (Clostridioides) difficile is recognized as the major cause of healthcare antibiotic-associated diarrhea. We surveyed a molecular epidemiological correlation between the clinical isolates from two general hospitals in Iran through clustering toxigenic types and antibiotic susceptibility testing (AST) accuracy. Methods. Study population included 460 diarrhoeic specimens from inpatients with a history of antibiotic therapy. All samples underwent enriched anaerobic culture, confirmed by detection of gluD gene with PCR. Toxin status and AST were assessed by the disk diffusion method (DDM) and minimal inhibitory concentrations (MICs) of metronidazole, vancomycin, and rifampin. C. difficile outbreak was analyzed through conventional PCR by tracing toxin genes and Homebrew pulsed-field gel electrophoresis (PFGE) for characterizing isolates within our healthcare systems. Results. A total of 29 C. difficile strains were isolated by enriched anaerobic culture from the clinical samples. Among them, 22 (4.8%) toxigenic profiles yielded toxins A and B (tcdA, tcdB) and binary toxins (cdtA, cdtB). The minimum inhibitory concentration (MIC) was 18.1% and 9% for vancomycin and metronidazole, and all isolates were susceptible to rifampicin and its minimum inhibitory concentration was at <0.003 μg/mL. The most dominant toxigenic and antibiotic-resistant “pulsotype F” was detected through PFGE combined with multiple Clostridial toxigenic pattern and AST. Conclusions. DNA fingerprinting studies represent a powerful tool in surveying hypervirulent C. difficile strains in clinical settings. Resistance to vancomycin and metronidazole, as first-line antibiotics, necessitate accomplishment of proper control strategies and also prescription of tigecycline as a more appropriate option.

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Prevalence, genetic relatedness and antibiotic resistance of hospital-acquired clostridium difficile PCR ribotype 018 strains

Cited by 12 publications

References 25 publications

Different molecular characteristics and antimicrobial resistance profiles of Clostridium difficile in the Asia-Pacific region

Different molecular characteristics and antimicrobial resistance profiles of Clostridium difficile in the Asia-Pacific region

Clostridium difficile in Asia: Opportunities for One Health Management

Phenotypical and Genotypical Comparison of Clostridium difficile Isolated from Clinical Samples: Homebrew DNA Fingerprinting versus Antibiotic Susceptibility Testing (AST) and Clostridial Toxin Genes

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