Publication details

Two Clusters of Fluoroquinolone and Clindamycin-Resistant Clostridium difficile PCR Ribotype 001 Strain Recognized by Capillary Electrophoresis Ribotyping and Multilocus Variable Tandem Repeat Analysis

Authors

NYC O. TEJKALOVÁ Renata KŘÍŽ Zdeněk RŮŽIČKA Filip KUBÍČEK Luboš MATEJKOVA J. KUIJPER E. KRUTOVA M.

Year of publication 2017
Type Article in Periodical
Magazine / Source Microbial Drug Resistance
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.1089/mdr.2016.0159
Field Microbiology, virology
Keywords Clostridium difficile; PCR ribotype 001; capillary electrophoresis ribotyping; MLVA; antimicrobial drug resistance; Thr82Ile
Description Aim: To perform a retrospective analysis of the high occurrence of Clostridium difficile infection in the surgical department of a Czech tertiary care hospital and to identify weaknesses in C. difficile infection (CDI) prevention and control policies. Methods: Clinical and epidemiological data on eleven CDI cases were collected. C. difficile isolates were characterized by capillary electrophoresis ribotyping, multilocus variable tandem repeat analysis (MLVA), gyrA gene fragment sequencing, and erm(B) fragment PCR amplification. Antibiotic susceptibility to metronidazole, vancomycin, ciprofloxacin, moxifloxacin, and clindamycin was tested. Findings: Eleven CDI cases were caused by C. difficile PCR ribotype 001 strains. These strains revealed two different MLVA profiles with 11 tandem repeat differences. All isolates were susceptible to metronidazole and vancomycin and resistant to ciprofloxacin (MIC 32mg/L), moxifloxacin (MIC 32mg/L), and clindamycin (MIC 256mg/L). All isolates revealed amino acid substitution Thr82Ile, in the GyrA and were erm(B) negative. Conclusion: Two fluoroquinolone and clindamycin-resistant C. difficile PCR ribotype 001 strain clusters occurred at one of the surgical departments of a tertiary care hospital. Ineffective decontamination with suboptimal concentration and time of exposure of sporicidal disinfectants may have resulted in C. difficile transmission.

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