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Two Clusters of Fluoroquinolone and Clindamycin-Resistant Clostridium difficile PCR Ribotype 001 Strain Recognized by Capillary Electrophoresis Ribotyping and Multilocus Variable Tandem Repeat Analysis.
Microb Drug Resist. 2017 Jul; 23(5):609-615.MD

Abstract

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 ≥32 mg/L), moxifloxacin (MIC ≥32 mg/L), and clindamycin (MIC ≥256 mg/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.

Authors+Show Affiliations

1 Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital , Praha, Czech Republic .2 Department of Medical Microbiology, St. Anne's University Hospital, and Faculty of Medicine, Masaryk University , Brno, Czech Republic .3 2nd Department of Surgery, St. Anne's University Hospital, and Faculty of Medicine, Masaryk University , Brno, Czech Republic .2 Department of Medical Microbiology, St. Anne's University Hospital, and Faculty of Medicine, Masaryk University , Brno, Czech Republic .3 2nd Department of Surgery, St. Anne's University Hospital, and Faculty of Medicine, Masaryk University , Brno, Czech Republic .1 Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital , Praha, Czech Republic .4 Leiden University Medical Centre , Leiden, the Netherlands .1 Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital , Praha, Czech Republic . 5 DNA Laboratory, Department of Pediatric Neurology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital , Praha, Czech Republic .

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27860531

Citation

Nyc, Otakar, et al. "Two Clusters of Fluoroquinolone and Clindamycin-Resistant Clostridium Difficile PCR Ribotype 001 Strain Recognized By Capillary Electrophoresis Ribotyping and Multilocus Variable Tandem Repeat Analysis." Microbial Drug Resistance (Larchmont, N.Y.), vol. 23, no. 5, 2017, pp. 609-615.
Nyc O, Tejkalova R, Kriz Z, et al. Two Clusters of Fluoroquinolone and Clindamycin-Resistant Clostridium difficile PCR Ribotype 001 Strain Recognized by Capillary Electrophoresis Ribotyping and Multilocus Variable Tandem Repeat Analysis. Microb Drug Resist. 2017;23(5):609-615.
Nyc, O., Tejkalova, R., Kriz, Z., Ruzicka, F., Kubicek, L., Matejkova, J., Kuijper, E., & Krutova, M. (2017). Two Clusters of Fluoroquinolone and Clindamycin-Resistant Clostridium difficile PCR Ribotype 001 Strain Recognized by Capillary Electrophoresis Ribotyping and Multilocus Variable Tandem Repeat Analysis. Microbial Drug Resistance (Larchmont, N.Y.), 23(5), 609-615. https://doi.org/10.1089/mdr.2016.0159
Nyc O, et al. Two Clusters of Fluoroquinolone and Clindamycin-Resistant Clostridium Difficile PCR Ribotype 001 Strain Recognized By Capillary Electrophoresis Ribotyping and Multilocus Variable Tandem Repeat Analysis. Microb Drug Resist. 2017;23(5):609-615. PubMed PMID: 27860531.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Two Clusters of Fluoroquinolone and Clindamycin-Resistant Clostridium difficile PCR Ribotype 001 Strain Recognized by Capillary Electrophoresis Ribotyping and Multilocus Variable Tandem Repeat Analysis. AU - Nyc,Otakar, AU - Tejkalova,Renata, AU - Kriz,Zdenek, AU - Ruzicka,Filip, AU - Kubicek,Lubos, AU - Matejkova,Jana, AU - Kuijper,Ed, AU - Krutova,Marcela, Y1 - 2016/11/18/ PY - 2016/11/20/pubmed PY - 2018/3/31/medline PY - 2016/11/19/entrez KW - Clostridium difficile KW - MLVA KW - PCR ribotype 001 KW - Thr82Ile KW - antimicrobial drug resistance KW - capillary electrophoresis ribotyping SP - 609 EP - 615 JF - Microbial drug resistance (Larchmont, N.Y.) JO - Microb Drug Resist VL - 23 IS - 5 N2 - 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 ≥32 mg/L), moxifloxacin (MIC ≥32 mg/L), and clindamycin (MIC ≥256 mg/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. SN - 1931-8448 UR - https://www.unboundmedicine.com/medline/citation/27860531/Two_Clusters_of_Fluoroquinolone_and_Clindamycin_Resistant_Clostridium_difficile_PCR_Ribotype_001_Strain_Recognized_by_Capillary_Electrophoresis_Ribotyping_and_Multilocus_Variable_Tandem_Repeat_Analysis_ L2 - https://www.liebertpub.com/doi/10.1089/mdr.2016.0159?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -