Antimicrobial susceptibility and resistance mechanisms of clinical Clostridium difficile from a Chinese tertiary hospital

Dong, De-Li; Zhang, Lihua; Xu, Chen; Jiang, Cen; Yu, Bo; Wang, Xuefeng; Peng, Yibing

doi:10.1016/j.ijantimicag.2012.08.011

Cited by 56 publications

(45 citation statements)

References 13 publications

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“…All of their findings were similar to our results. Similar results have been reported by Hecht et al (2007) (Maywood) (27), Pelaez et al (2002) (Spain) (28), Dong et al (2013) (China) (29), Goudarzi et al (2013) (Iran) (30), Rao et al (2015) (Nashville) (31) and MacCannell et al (2006) (Canada) (32). …”

Section: Discussionsupporting

confidence: 83%

Detection, Ribotyping and Antimicrobial Resistance Properties of Clostridium difficile Strains Isolated From The Cases of Diarrhea

2016

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Background:Clostridium difficile is the most prevalent cause of antibiotic-associated infectious diarrhea al-around the world. Prevalence of virulent and resistant strains of Clostridium difficile is increasing now a day. The present investigation was carried out to study the prevalence, ribotyping and antibiotic resistance pattern of C. difficile isolated from diarrheic and non-diarrheic pediatrics.Materials and methods:Four-hundred stool specimens were collected from the diarrheic and non-diarrheic pediatrics hospitalized due to the diseases other than diarrhea. Samples were cultured and their positive results were subjected to disk diffusion and PCR-based ribotyping.Results:Thirty-five out of 400 (8.75%) samples were positive for C. difficile. Prevalence of C. difficile in diarrheic and non-diarrheic pediatrics were 11.25% and 4.16%, respectively. Male had the higher prevalence of bacteria than female (P < 0.05). eight to twelve months old pediatrics were the most commonly infected group. R27 (14.28%), R1 (10.71%), R12 (7.14%), R13 (7.14%) and R18 (7.14%) were most commonly detected ribotypes. There were no positive results for studied ribotypes in non-diarrheic pediatrics. C. difficile strains had the highest levels of resistance against tetracycline (71.42%), erythromycin (57.14%), moxifloxacin (48.57%), metronidazole (28.57%) and clindamycin (22.85%) antibiotics.Conclusion:Prescription of antibiotics in diarrheic pediatrics, males and also 8-12 months old pediatrics should be done in a regular and cautious manner.

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Section: Discussionsupporting

confidence: 83%

Detection, Ribotyping and Antimicrobial Resistance Properties of Clostridium difficile Strains Isolated From The Cases of Diarrhea

2016

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“…Of the 302 isolates tested with vancomycin in our study, 40 (13.2%) showed reduced susceptibility, similar to that shown in other recent studies (14)(15)(16).…”

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confidence: 91%

Strain Types and Antimicrobial Resistance Patterns of Clostridium difficile Isolates from the United States, 2011 to 2013

Tickler¹,

Goering

Whitmore³

et al. 2014

Antimicrob Agents Chemother

107

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We determined the PCR ribotypes and antimicrobial susceptibility patterns of 508 toxigenic Clostridium difficile isolates collected between 2011 and 2013 from 32 U.S. hospitals. Of the 29 PCR ribotypes identified, the 027 strain type was the most common (28.1%), although the rates varied by geographic region. Ribotype 014/020 isolates appear to be emerging. Clindamycin and moxifloxacin resistances (36.8% and 35.8%, respectively) were the most frequent resistance phenotypes observed. Reduced susceptibility to vancomycin was observed in 39.1% of 027 isolates.

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“…However, the sensitivity of the LAMP assay was shown to be 10-fold greater than that of conventional PCR, suggesting that there may be an important benefit in using this more cost-effective assay in countries with low economic growth. Besides, the positive rate of ermB dramatically reached 78.8 %, which is higher than other reports from China (58.3-69.1 %) (Huang et al, 2010;Dong et al, 2013). This may be explained by the regional difference in C. difficile populations.…”

Section: Discussionmentioning

confidence: 58%

Rapid detection of ermB gene in Clostridium difficile by loop-mediated isothermal amplification

Lin

Liu

Wang

et al. 2015

Journal of Medical Microbiology

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Macrolide-lincosamide-streptogramin B resistance in Clostridium difficile is mostly due to the ermB resistance determinant. Here, we describe a sensitive and rapid molecular method to detect ermB in C. difficile to contribute to the wider epidemiological study. Five sets of loop-mediated isothermal amplification (LAMP) primers were designed and optimized for rapid detection of ermB. The specificity and sensitivity of the primers for ermB were detected, and the ermB LAMP assay was compared to conventional PCR with 80 clinical isolates of C. difficile. Real-time monitoring of turbidity and chromogenic reaction were used to determine negative and positive results. A total of 26 pathogenic bacterial strains of different species were found to be negative for ermB, which indicated the high specificity of the primers. ermB was detected in 78.8 % (63/80) of the clinical isolates by both LAMP and conventional PCR. The detection limit of LAMP was 36.1 pg DNA ml 21 and its sensitivity was 10-fold greater than that of conventional PCR. This study is the first report regarding the development and application of the LAMP assay for detection of the ermB gene in C. difficile strains. The developed LAMP method is sensitive, specific and provides a user-friendly visual approach for the rapid detection of ermB-bearing C. difficile. Received 27 March 2015Accepted 13 June 2015 INTRODUCTIONClostridium difficile is a causative agent of antibiotic-associated diarrhoea and pseudomembranous colitis, usually as a consequence of antimicrobial therapy. During the last few decades, C. difficile infection (CDI) has become more severe, more recurrent, more resistant to antibiotics and more refractory to standard treatment, which poses a significant burden on patients, healthcare systems and society in general. Estimates suggest that the annual costs for management of CDI amount to more than $3 billion in the USA and J3 billion in Europe (Bouza, 2012;McGlone et al., 2012). Major risk factors for CDI include hospitalization, advanced age and antibiotic exposure, the latter including clindamycin and erythromycin (Aziz et al., 2001;Gerding, 1989;Kelly et al., 1994;Slimings & Riley, 2014). The majority of epidemic isolates are resistant to clindamycin, erythromycin, broad-spectrum cephalosporins and fluoroquinolones (Johnson et al., 1999; Spigaglia et al., 2011;Slimings & Riley, 2014). Thus, resistance to clindamycin and erythromycin, two antibiotics of the macrolidelincosamide-streptogramin B (MLSB) group, would further increase the risk of CDI.In C. difficile, resistance to the MLSB group of antibiotics is mainly encoded by the ermB resistance determinant. The ermB gene encodes a 23S rRNA methyltransferase that modifies the target site for the antibiotic and is located on a specific mobilizable non-conjugative element, Tn5398 (Farrow et al., 2001). However, the ermB gene is located on elements other than Tn5398 in the majority of clinical isolates. In total, 17 genetic organizations of such elements 3These authors contributed equally to this work...

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Antimicrobial susceptibility and resistance mechanisms of clinical Clostridium difficile from a Chinese tertiary hospital

Cited by 56 publications

References 13 publications

Detection, Ribotyping and Antimicrobial Resistance Properties of Clostridium difficile Strains Isolated From The Cases of Diarrhea

Detection, Ribotyping and Antimicrobial Resistance Properties of Clostridium difficile Strains Isolated From The Cases of Diarrhea

Strain Types and Antimicrobial Resistance Patterns of Clostridium difficile Isolates from the United States, 2011 to 2013

Rapid detection of ermB gene in Clostridium difficile by loop-mediated isothermal amplification

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