Ribotypes and New Virulent Strains Across Europe

Couturier, Jeanne; Davies, Kelvin J.A.; Gateau, Cécile; Barbut, Frédéric

doi:10.1007/978-3-319-72799-8_4

Cited by 31 publications

(23 citation statements)

References 72 publications

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“…The toxin gene profile is varying in C. difficile strains, and some of them belong to a particular RT. For example, the hypervirulent ribotype NAP1/BI/O27 potentially overexpressed toxins A and B, and also harbored binary toxin genes ( cdtA / cdtB ), which had increased CDI greater disease severity and mortality . In our study, RTO27 was completely absent.…”

Section: Discussionmentioning

confidence: 58%

Molecular typing of Clostridioides difficile isolates from clinical and non‐clinical samples in Iran

Kouhsari

Douraghi

Yaseri

et al. 2019

APMIS

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Clostridioides difficile is a major cause of nosocomial infectious diarrhea in hospitalized patients throughout the world. We aimed to characterize C. difficile isolates among hospitalized patients, hospital staffs, and hospital environment samples obtained in three tertiary care hospitals of Iran with regard to their molecular types between June 2016 and November 2017. The toxigenicity of C. difficile isolates was determined by toxigenic culture and multiplex‐PCR. Toxigenic C. difficile isolates collected were ribotyped using capillary gel electrophoresis‐based PCR and the database of WEBRIBO (http://webribo.ages.at). Of 500 clinical and non‐clinical samples, toxigenic C. difficile were identified in 35 of 250 stool samples (14%) and in 3 of 250 swabs (1.2%). The most frequently found ribotypes (RTs) were 039, AI‐12, and AI‐21 (15.8, 10.52, and 10.52% of all isolates, respectively). Further RTs were: 017, 001, AI‐3, AI‐15, AI‐18, AI‐10, AI‐4, and PR21195 (as new ribotype). The epidemic RTs (027 and 078) seen in the Europe, North America, and Asia were completely absent in this study.

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Section: Discussionmentioning

confidence: 58%

Molecular typing of Clostridioides difficile isolates from clinical and non‐clinical samples in Iran

Kouhsari

Douraghi

Yaseri

et al. 2019

APMIS

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“…The epidemiology of C. difficile has changed in recent decades with the circulation of new PCR ribotypes with different potential spread both in Europe and worldwide [12]. Recent literature suggests that clones could disseminate internationally with a zoonotic/anthroponotic transmission [10].…”

Section: Introductionmentioning

confidence: 99%

Clostridioides difficile in Calves in Central Italy: Prevalence, Molecular Typing, Antimicrobial Susceptibility and Association with Antibiotic Administration

Blasi

Lovito

Albini

et al. 2021

Animals

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The emergence of Clostridioides difficile as the main agent of antibiotic-associated diarrhoea has raised concerns about its potential zoonotic role in different animal species. The use of antimicrobials is a major risk factor for C. difficile infection. Here, we provide data on C. difficile infection in dairy and beef calves in Umbria, a region in central Italy. This cross-sectional study focuses on prevalence, risk factors, ribotypes, toxinotypes and antimicrobial resistance profiles of circulating ribotypes. A prevalence of 19.8% (CI95%, 12–27.6%) positive farms was estimated, and the prescription of penicillins on the farms was associated with C. difficile detection (OR = 5.58). Eleven different ribotypes were found, including the ST11 sublineages RT-126 and -078, which are also commonly reported in humans. Thirteen isolates out of 17 showed resistance to at least one of clindamycin, moxifloxacin, linezolid and vancomycin. Among them, multiple-drug resistance was observed in two isolates, belonging to RT-126. Furthermore, RT-126 isolates were positive for tetracycline resistance determinants, confirming that tetracycline resistance is widespread among ST11 isolates from cattle. The administration of penicillins increased the risk of C. difficile in calves: this, together with the recovery of multi-resistant strains, strongly suggests the need for minimising antibiotic misuse on cattle farms.

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“…In recent years, rare but hypervirulent pathogens have been increasingly reported in specific geographic regions (1, 2), often associated with refugees and asylum seekers (3), but also in other high-risk populations including hospitalized patients (4, 5), the elderly, and newborns (6, 7). Reports of infections in refugees over the past decade have included Borrelia recurrentis (8), methicillin resistant Staphylococcus aureus ( S. aureus) (MRSA) (9, 10), and toxigenic Corynebacterium diphtheriae (11).…”

Section: Introductionmentioning

confidence: 99%

Whole Genome Sequencing for Surveillance of Diphtheria in Low Incidence Settings

Seth-Smith

Egli

2019

Front. Public Health

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Corynebacterium diphtheriae ( C. diphtheriae ) is a relatively rare pathogen in most Western countries. While toxin producing strains can cause pharyngeal diphtheria with potentially fatal outcomes, the more common presentation is wound infections. The diphtheria toxin is encoded on a prophage and can also be carried by Corynebacterium ulcerans and Corynebacterium pseudotuberculosis . Currently, across Europe, infections are mainly diagnosed in travelers and refugees from regions where diphtheria is more endemic, patients from urban areas with poor hygiene, and intravenous drug users. About half of the cases are non-toxin producing isolates. Rapid identification of the bacterial pathogen and toxin production is a critical element of patient and outbreak management. Beside the immediate clinical management of the patient, public health agencies should be informed of toxigenic C. diphtheriae diagnoses as soon as possible. The collection of case-related epidemiological data from the patient is often challenging due to language barriers and social circumstances. However, information on patient contacts, vaccine status and travel/refugee route, where appropriate, is critical, and should be documented. In addition, isolates should be characterized using high resolution typing, in order to identify transmissions and outbreaks. In recent years, whole genome sequencing (WGS) has become the gold standard of high-resolution typing methods, allowing detailed investigations of pathogen transmissions. De-centralized sequencing strategies with redundancy in sequencing capacities, followed by data exchange may be a valuable future option, especially since WGS becomes more available and portable. In this context, the sharing of sequence data, using public available platforms, is essential. A close interaction between microbiology laboratories, treating physicians, refugee centers, social workers, and public health officials is a key element in successful management of suspected outbreaks. Analyzing bacterial isolates at reference centers may further help to provide more specialized microbiological techniques and to standardize information, but this is also more time consuming during an outbreak. Centralized communication strategies between public health agencies and laboratories helps considerably in establishing and coordinating effective surveillance and infection control. We review the current literature on high-resolution typing of C. diphtheriae and share our own experience with the coordination of a Swiss-German outbreak.

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Ribotypes and New Virulent Strains Across Europe

Cited by 31 publications

References 72 publications

Molecular typing of Clostridioides difficile isolates from clinical and non‐clinical samples in Iran

Molecular typing of Clostridioides difficile isolates from clinical and non‐clinical samples in Iran

Clostridioides difficile in Calves in Central Italy: Prevalence, Molecular Typing, Antimicrobial Susceptibility and Association with Antibiotic Administration

Whole Genome Sequencing for Surveillance of Diphtheria in Low Incidence Settings

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