Tags

Type your tag names separated by a space and hit enter

Effect of metronidazole on growth and toxin production by epidemic Clostridium difficile PCR ribotypes 001 and 027 in a human gut model.
J Antimicrob Chemother. 2007 Jul; 60(1):83-91.JA

Abstract

OBJECTIVES

We compared the behaviour of Clostridium difficile PCR ribotypes 001 and 027 in a human gut model, and compared the responses to metronidazole exposure.

METHODS

Using a human gut model primed with pooled human faeces, gut flora bacterial counts, C. difficile total viable counts, spore counts and cytotoxin titres were determined, following exposure to clindamycin, in the absence or presence of metronidazole.

RESULTS

Duration of cytotoxin production by C. difficile ribotype 027 was markedly longer than that of ribotype 001 (23 versus 13 days, respectively), but peak toxin titres were similar. During toxin production, total C. difficile ribotype 027 populations had higher proportions of vegetative cells than did ribotype 001 (median 56.33 versus 23.54%). Similarly, total C. difficile ribotype 027 populations remained predominantly as vegetative cells for longer than did ribotype 001 (20 versus 9 days). The effects of metronidazole on C. difficile were markedly less than expected. Titres of C. difficile ribotype 001 cytotoxin were reduced but recurred following metronidazole administration. C. difficile ribotype 027 cytotoxin titres in the distal section of the gut model were unaffected by metronidazole. These observations correlated with poor metronidazole concentrations.

CONCLUSIONS

Duration of cytotoxin production by C. difficile ribotype 027 markedly exceeds that of ribotype 001. Sub-optimal gut concentrations of metronidazole, possibly due to inactivation by components of normal gut flora, are associated with continued toxin production. These findings may help to explain the increased severity of symptoms and higher case-fatality ratio associated with infections due to C. difficile ribotype 027.

Authors+Show Affiliations

Department of Microbiology, Leeds Teaching Hospital and University of Leeds, Leeds LS1 3EX, UK.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17483547

Citation

Freeman, Jane, et al. "Effect of Metronidazole On Growth and Toxin Production By Epidemic Clostridium Difficile PCR Ribotypes 001 and 027 in a Human Gut Model." The Journal of Antimicrobial Chemotherapy, vol. 60, no. 1, 2007, pp. 83-91.
Freeman J, Baines SD, Saxton K, et al. Effect of metronidazole on growth and toxin production by epidemic Clostridium difficile PCR ribotypes 001 and 027 in a human gut model. J Antimicrob Chemother. 2007;60(1):83-91.
Freeman, J., Baines, S. D., Saxton, K., & Wilcox, M. H. (2007). Effect of metronidazole on growth and toxin production by epidemic Clostridium difficile PCR ribotypes 001 and 027 in a human gut model. The Journal of Antimicrobial Chemotherapy, 60(1), 83-91.
Freeman J, et al. Effect of Metronidazole On Growth and Toxin Production By Epidemic Clostridium Difficile PCR Ribotypes 001 and 027 in a Human Gut Model. J Antimicrob Chemother. 2007;60(1):83-91. PubMed PMID: 17483547.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of metronidazole on growth and toxin production by epidemic Clostridium difficile PCR ribotypes 001 and 027 in a human gut model. AU - Freeman,Jane, AU - Baines,Simon D, AU - Saxton,Katie, AU - Wilcox,Mark H, Y1 - 2007/05/05/ PY - 2007/5/8/pubmed PY - 2007/9/18/medline PY - 2007/5/8/entrez SP - 83 EP - 91 JF - The Journal of antimicrobial chemotherapy JO - J Antimicrob Chemother VL - 60 IS - 1 N2 - OBJECTIVES: We compared the behaviour of Clostridium difficile PCR ribotypes 001 and 027 in a human gut model, and compared the responses to metronidazole exposure. METHODS: Using a human gut model primed with pooled human faeces, gut flora bacterial counts, C. difficile total viable counts, spore counts and cytotoxin titres were determined, following exposure to clindamycin, in the absence or presence of metronidazole. RESULTS: Duration of cytotoxin production by C. difficile ribotype 027 was markedly longer than that of ribotype 001 (23 versus 13 days, respectively), but peak toxin titres were similar. During toxin production, total C. difficile ribotype 027 populations had higher proportions of vegetative cells than did ribotype 001 (median 56.33 versus 23.54%). Similarly, total C. difficile ribotype 027 populations remained predominantly as vegetative cells for longer than did ribotype 001 (20 versus 9 days). The effects of metronidazole on C. difficile were markedly less than expected. Titres of C. difficile ribotype 001 cytotoxin were reduced but recurred following metronidazole administration. C. difficile ribotype 027 cytotoxin titres in the distal section of the gut model were unaffected by metronidazole. These observations correlated with poor metronidazole concentrations. CONCLUSIONS: Duration of cytotoxin production by C. difficile ribotype 027 markedly exceeds that of ribotype 001. Sub-optimal gut concentrations of metronidazole, possibly due to inactivation by components of normal gut flora, are associated with continued toxin production. These findings may help to explain the increased severity of symptoms and higher case-fatality ratio associated with infections due to C. difficile ribotype 027. SN - 0305-7453 UR - https://www.unboundmedicine.com/medline/citation/17483547/Effect_of_metronidazole_on_growth_and_toxin_production_by_epidemic_Clostridium_difficile_PCR_ribotypes_001_and_027_in_a_human_gut_model_ L2 - https://academic.oup.com/jac/article-lookup/doi/10.1093/jac/dkm113 DB - PRIME DP - Unbound Medicine ER -