Molecular epidemiology and antimicrobial susceptibility of human Clostridium difficile isolates from a single institution in Northern China

Abstract

Because the epidemiology of Clostridium difficile infection (CDI) is region-specific, the present study was undertaken to examine the epidemiology of C difficile outbreaks in Beijing, China.Eighty nonduplicate isolates were collected from March, 2016 to December, 2016. The molecular type and phylogenetic analysis were evaluated by multilocus sequence typing (MLST). The minimum inhibitory concentrations (MICs) for 11 antibiotics and the resistance mechanisms were investigated.Sixty-five toxigenic strains (81.25%), including 22 tcdA-B+CDT- strains (27.5%) and 43 tcdA+B+CDT- strains (53.75%), and also 15 nontoxigenic strains (tcdA-B-CDT-; 18.75%) were detected. MLST identified 21 different sequence types (STs), including 2 novel types (ST409 and ST416). All isolates were susceptible to metronidazole, vancomycin, fidaxomicin, piperacillin/tazobactam, and meropenem, and all were effectively inhibited by emodin (MICs 4–8 μg/mL). The resistance rates to rifaximin, ceftriaxone, clindamycin, erythromycin, and ciprofloxacin were 8.75%, 51.25%, 96.25%, 81.25%, and 96.25%, respectively; 81.25% (65/80) of isolates were multidrug-resistant. Amino acid mutations in GyrA and/or GyrB conferred quinolone resistance. One novel amino acid substitution, F86Y in GyrA, was found in 1 CIP-intermediate strain. The erm(B) gene played a key role in mediating macrolide-lincosamide-streptogramin B (MLSB) resistance. Erm(G) was also found in erm(B)-negative strains that were resistant to both erythromycin and clindamycin. RpoB mutations were associated with rifampin resistance, and 2 new amino mutations were identified in 1 intermediate strain (E573A and E603N).Regional diversity and gene heterogeneity exist in both the ST type and resistant patterns of clinical C difficile isolates in Northern China.

Hypervirulent clade 2, ribotype 019/sequence type 67 Clostridioides difficile strain from Japan

“…We detected only a C656T nucleotide substitution within the 23S rRNA copy on the genome with CARD. However, as a previous study suggested, the substitution has been not associated with conferring resistance to macrolides and lincosamides in C. difficile [41]. Our findings obtained from the resistome analysis seem to be sound and coincide with phenotypic results of antibiotic MICs.…”

Integrated genomic epidemiology and phenotypic profiling of Clostridium difficile across intra-hospital and community populations in Colombia

“…difficile , these studies have been based on ribotyping and had a purely descriptive approach 26 . The comparison of the findings with studies worldwide reveals a similar profile in that ST-8, the most frequent in this study, has been reported in the United Kingdom 27 , Australia 28 , China 29 and United States 30 , usually associated with recurrent infections, in coinfection with a second ST, also showing substitutions associated with resistance to antibiotics (at the level of gyrA and gyrB ) 27,29 .…”

Clostridium difficile in Asia: Opportunities for One Health Management

“…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].…”