New PCR ribotypes of Clostridium difficile detected in children in Brazil

Abstract

A total of 35 Brazilian isolates of Clostridium difficile from faecal stools and four isolates from hospital environments were analyzed by PCR ribotyping. A whole cell protein profile (as an alternative for serogrouping), in vitro toxin production and susceptibility to vancomycin, metronidazole and clindamycin were also investigated. All strains were typeable by both phenotypic and genotypic methods, and a total of 13 different PCR ribotypes were identified, of which seven (132, 133, 134, 135, 136, 142 and 143) were considered new types and accounted for 78.5% of all samples evaluated (including hospital environments). A non-toxigenic C. difficile PCR ribotype 133 was detected in all children groups examined (inpatients, outpatients and healthy children), whilst toxigenic PCR ribotypes 015, 131, 134 and 135 were associated mostly with symptomatic children. Serogroups G and D were disseminated both in patients from the community and from the pediatric hospital, with group G prevalent among outpatient children. All strains were susceptible to vancomycin and metronidazole but high levels of resistance to clindamycin were found, especially among serogroups G and D. Co-existence of different ribotypes and serogroups in the same individual was observed. The new seven ribotypes found in this investigation may represent strains characteristic of this region of Brazil.

Detection of cross-infection associated to a Brazilian PCR-ribotype of Clostridium difficile in a university hospital in Rio de Janeiro, Brazil

“…A specific clone, PCR-ribotype 133, accounted for 50% of the isolates. This ribotype had already been detected by our group in previous work realized 11 years ago at the children's hospital ''Instituto Pediátrico Professor Martagão Gesteira'' (IPPMG), localized on the same University campus as HUCFF (Alcides et al 2007). This PCR-ribotype is considered an exclusively Brazilian ribotype, since it has never been isolated elsewhere.…”

“…In Brazil, few data concerning the importance of CDI and the incidence of clonal types of C. difficile exist (Pinto et al 2003;Alcides et al 2007;Balassiano et al 2009). Therefore, the aim of this work was to isolate and characterize phenotypically and genotypically C. difficile strains from samples obtained from a University Hospital in Rio de Janeiro city, Brazil.…”

Clostridium difficile: a problem of concern in developed countries and still a mystery in Latin America

“…The study, therefore, highlighted the importance of hand washing before and after procedures, as well as a need to adopt precautionary measures for contact with patients suffering from diarrhoea. Alcides et al (2007) conducted a study with the aim of characterizing C. difficile strains isolated from children (3 months-7 years of age) with or without diarrhoea, as well as strains isolated from hospital environments. A total of 39 strains were obtained: 15 from hospitalized children with diarrhoea, 17 from outpatients with diarrhoea, four from healthy children, and four from the general hospital environment.…”

Genes Encoding Toxin ofClostridium difficilein Children with and without Diarrhea

“…In Brazil, few studies have shown the presence of toxigenic C. difficile harboring tcdA and/or tcdB but not the binary toxin genes in stool samples from children with acute diarrhea [4, 5]. …”