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Surveillance for antimicrobial resistance in Australian isolates of Clostridium difficile, 2013-14.
J Antimicrob Chemother. 2015 Nov; 70(11):2992-9.JA

Abstract

OBJECTIVES

The objective of this study was to determine the activity of fidaxomicin and comparator antimicrobials against Clostridium difficile isolated from patients with C. difficile infection (CDI) in Australian hospitals and in the community.

METHODS

One private and one public laboratory from five states in Australia submitted a total of 474 isolates/PCR-positive stool samples during three collection periods in August-September 2013 (n = 175), February-March 2014 (n = 134) and August-September 2014 (n = 165). Isolate identification was confirmed by selective culture for C. difficile and a proportion of isolates from each state were characterized by PCR for toxin genes and PCR ribotyping. MICs of fidaxomicin and eight comparator antimicrobials were determined for all isolates using agar methodology.

RESULTS

Site collection yielded 440 isolates of C. difficile and PCR revealed a heterogeneous strain population comprising 37 different PCR ribotypes (RTs), 95% of which were positive for tcdA and tcdB (A+B+). The most common RTs were 014 (29.8%) and 002 (15.9%). Epidemic RT 027 was not identified; however, small numbers of virulent RTs 078 and 244 were found. Resistance to vancomycin, metronidazole and fidaxomicin was not detected and resistance to moxifloxacin was very low (3.4%). Fidaxomicin showed potent in vitro activity against all 440 isolates (MIC50/MIC90 0.03/0.12 mg/L) and was superior to metronidazole (MIC50/MIC90 0.25/0.5 mg/L) and vancomycin (MIC50/MIC90 1/2 mg/L).

CONCLUSIONS

These data confirm the potent in vitro activity of fidaxomicin against C. difficile. Moreover, this study provides an important baseline for ongoing long-term surveillance of antimicrobial resistance and prospective tracking of prominent and emerging strain types.

Authors+Show Affiliations

Microbiology and Immunology, School of Pathology and Laboratory Medicine, The University of Western Australia, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia.Healthscope Pathology, Microbiology Department, Wayville, South Australia, Australia.Department of Microbiology, Pathology North, Royal North Shore Hospital, St Leonards, New South Wales, Australia.Monash Infectious Diseases, Monash Health, Monash University, Clayton, Victoria, Australia.Monash Infectious Diseases, Monash Health, Monash University, Clayton, Victoria, Australia.Microbiology and Infectious Diseases Laboratories, SA Pathology, Adelaide, South Australia, Australia.University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.Melbourne Pathology, Collingwood, Victoria, Australia.University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.Sullivan Nicolaides Pathology, Taringa, Queensland, Australia.Melbourne Pathology, Collingwood, Victoria, Australia.Douglass Hanly Moir Pathology, Macquarie Park, New South Wales, Australia.Microbiology and Infectious Diseases Laboratories, SA Pathology, Adelaide, South Australia, Australia.Healthscope Pathology, Microbiology Department, Wayville, South Australia, Australia.Microbiology and Immunology, School of Pathology and Laboratory Medicine, The University of Western Australia, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia Department of Microbiology, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia thomas.riley@uwa.edu.au.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26221017

Citation

Knight, Daniel R., et al. "Surveillance for Antimicrobial Resistance in Australian Isolates of Clostridium Difficile, 2013-14." The Journal of Antimicrobial Chemotherapy, vol. 70, no. 11, 2015, pp. 2992-9.
Knight DR, Giglio S, Huntington PG, et al. Surveillance for antimicrobial resistance in Australian isolates of Clostridium difficile, 2013-14. J Antimicrob Chemother. 2015;70(11):2992-9.
Knight, D. R., Giglio, S., Huntington, P. G., Korman, T. M., Kotsanas, D., Moore, C. V., Paterson, D. L., Prendergast, L., Huber, C. A., Robson, J., Waring, L., Wehrhahn, M. C., Weldhagen, G. F., Wilson, R. M., & Riley, T. V. (2015). Surveillance for antimicrobial resistance in Australian isolates of Clostridium difficile, 2013-14. The Journal of Antimicrobial Chemotherapy, 70(11), 2992-9. https://doi.org/10.1093/jac/dkv220
Knight DR, et al. Surveillance for Antimicrobial Resistance in Australian Isolates of Clostridium Difficile, 2013-14. J Antimicrob Chemother. 2015;70(11):2992-9. PubMed PMID: 26221017.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surveillance for antimicrobial resistance in Australian isolates of Clostridium difficile, 2013-14. AU - Knight,Daniel R, AU - Giglio,Steven, AU - Huntington,Peter G, AU - Korman,Tony M, AU - Kotsanas,Despina, AU - Moore,Casey V, AU - Paterson,David L, AU - Prendergast,Louise, AU - Huber,Charlotte A, AU - Robson,Jennifer, AU - Waring,Lynette, AU - Wehrhahn,Michael C, AU - Weldhagen,Gerhard F, AU - Wilson,Richard M, AU - Riley,Thomas V, Y1 - 2015/07/28/ PY - 2015/02/23/received PY - 2015/06/26/accepted PY - 2015/7/30/entrez PY - 2015/7/30/pubmed PY - 2016/8/3/medline SP - 2992 EP - 9 JF - The Journal of antimicrobial chemotherapy JO - J Antimicrob Chemother VL - 70 IS - 11 N2 - OBJECTIVES: The objective of this study was to determine the activity of fidaxomicin and comparator antimicrobials against Clostridium difficile isolated from patients with C. difficile infection (CDI) in Australian hospitals and in the community. METHODS: One private and one public laboratory from five states in Australia submitted a total of 474 isolates/PCR-positive stool samples during three collection periods in August-September 2013 (n = 175), February-March 2014 (n = 134) and August-September 2014 (n = 165). Isolate identification was confirmed by selective culture for C. difficile and a proportion of isolates from each state were characterized by PCR for toxin genes and PCR ribotyping. MICs of fidaxomicin and eight comparator antimicrobials were determined for all isolates using agar methodology. RESULTS: Site collection yielded 440 isolates of C. difficile and PCR revealed a heterogeneous strain population comprising 37 different PCR ribotypes (RTs), 95% of which were positive for tcdA and tcdB (A+B+). The most common RTs were 014 (29.8%) and 002 (15.9%). Epidemic RT 027 was not identified; however, small numbers of virulent RTs 078 and 244 were found. Resistance to vancomycin, metronidazole and fidaxomicin was not detected and resistance to moxifloxacin was very low (3.4%). Fidaxomicin showed potent in vitro activity against all 440 isolates (MIC50/MIC90 0.03/0.12 mg/L) and was superior to metronidazole (MIC50/MIC90 0.25/0.5 mg/L) and vancomycin (MIC50/MIC90 1/2 mg/L). CONCLUSIONS: These data confirm the potent in vitro activity of fidaxomicin against C. difficile. Moreover, this study provides an important baseline for ongoing long-term surveillance of antimicrobial resistance and prospective tracking of prominent and emerging strain types. SN - 1460-2091 UR - https://www.unboundmedicine.com/medline/citation/26221017/Surveillance_for_antimicrobial_resistance_in_Australian_isolates_of_Clostridium_difficile_2013_14_ L2 - https://academic.oup.com/jac/article-lookup/doi/10.1093/jac/dkv220 DB - PRIME DP - Unbound Medicine ER -