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High in vitro activity of fidaxomicin against Clostridium difficile isolates from a university teaching hospital in China.
J Microbiol Immunol Infect. 2018 Jun; 51(3):411-416.JM

Abstract

BACKGROUND

Clostridium difficile infection (CDI) is a significant cause of morbidity and mortality in both the acute care setting and the wider healthcare system. The purpose of this study was to evaluate the in vitro activity of fidaxomicin against C. difficile isolates from a university teaching hospital in China.

METHODS

One hundred and one C. difficile isolates were collected and analyzed for toxin genes by multiplex PCR. The toxin gene positive strains were also typed by multilocus sequence typing (MLST) and PCR-ribotyping. The MICs of the isolates were determined against fidaxomicin, metronidazole, vancomycin, tigecycline and moxifloxacin, by the agar dilution method.

RESULTS

All the 101 isolates exhibited low MICs to fidaxomicin (0.032-1 mg/L), metronidazole (0.125-1 mg/L), vancomycin (0.25-2 mg/L) and tigecycline (0.016-0.5 mg/L). Tigecycline showed the lowest geometric mean MIC value (0.041 mg/L), followed by fidaxomicin (0.227 mg/L), metronidazole (0.345 mg/L), and vancomycin (0.579 mg/L). About 35% of the strains (n = 35) were resistant to moxifloxacin, and the resistance rate to moxifloxacin for A-B+CDT- isolates (85.0%) was much higher than that of A+B+CDT- (15.7%) and A-B-CDT- (29.2%) isolates (P < 0.001). The MIC values of fidaxomicin, metronidazole, vancomycin and moxifloxacin against the 3 ST1 isolates were higher than for other STs. All the 28 moxifloxacin-resistant toxigenic isolates carried a mutation either in gyrA or/and gyrB.

CONCLUSION

Fidaxomicin exhibited high antimicrobial activity against all C. difficile isolates tested, which shows promise as a new drug for treating Chinese CDI patients.

Authors+Show Affiliations

Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China; Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China. Electronic address: yangqiwen81@163.com.Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China; Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.The Charles Sturt University, Leeds Parade, Orange, New South Wales, Australia; Centre for Infectious Diseases and Microbiology Laboratory Services, Westmead Hospital, Westmead, New South Wales, Australia.The Charles Sturt University, Leeds Parade, Orange, New South Wales, Australia.ZheJiang Hisun Pharmaceutical Co. ltd, Taizhou, Zhejiang, China.Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China. Electronic address: xycpumch@139.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28693926

Citation

Cheng, Jing-Wei, et al. "High in Vitro Activity of Fidaxomicin Against Clostridium Difficile Isolates From a University Teaching Hospital in China." Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi, vol. 51, no. 3, 2018, pp. 411-416.
Cheng JW, Yang QW, Xiao M, et al. High in vitro activity of fidaxomicin against Clostridium difficile isolates from a university teaching hospital in China. J Microbiol Immunol Infect. 2018;51(3):411-416.
Cheng, J. W., Yang, Q. W., Xiao, M., Yu, S. Y., Zhou, M. L., Kudinha, T., Kong, F., Liao, J. W., & Xu, Y. C. (2018). High in vitro activity of fidaxomicin against Clostridium difficile isolates from a university teaching hospital in China. Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi, 51(3), 411-416. https://doi.org/10.1016/j.jmii.2017.06.007
Cheng JW, et al. High in Vitro Activity of Fidaxomicin Against Clostridium Difficile Isolates From a University Teaching Hospital in China. J Microbiol Immunol Infect. 2018;51(3):411-416. PubMed PMID: 28693926.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High in vitro activity of fidaxomicin against Clostridium difficile isolates from a university teaching hospital in China. AU - Cheng,Jing-Wei, AU - Yang,Qi-Wen, AU - Xiao,Meng, AU - Yu,Shu-Ying, AU - Zhou,Meng-Lan, AU - Kudinha,Timothy, AU - Kong,Fanrong, AU - Liao,Jian-Wei, AU - Xu,Ying-Chun, Y1 - 2017/06/29/ PY - 2017/02/10/received PY - 2017/06/06/revised PY - 2017/06/16/accepted PY - 2017/7/12/pubmed PY - 2018/10/10/medline PY - 2017/7/12/entrez KW - Antimicrobial susceptibility KW - Clostridium difficile KW - Fidaxomicin KW - Resistance SP - 411 EP - 416 JF - Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi JO - J Microbiol Immunol Infect VL - 51 IS - 3 N2 - BACKGROUND: Clostridium difficile infection (CDI) is a significant cause of morbidity and mortality in both the acute care setting and the wider healthcare system. The purpose of this study was to evaluate the in vitro activity of fidaxomicin against C. difficile isolates from a university teaching hospital in China. METHODS: One hundred and one C. difficile isolates were collected and analyzed for toxin genes by multiplex PCR. The toxin gene positive strains were also typed by multilocus sequence typing (MLST) and PCR-ribotyping. The MICs of the isolates were determined against fidaxomicin, metronidazole, vancomycin, tigecycline and moxifloxacin, by the agar dilution method. RESULTS: All the 101 isolates exhibited low MICs to fidaxomicin (0.032-1 mg/L), metronidazole (0.125-1 mg/L), vancomycin (0.25-2 mg/L) and tigecycline (0.016-0.5 mg/L). Tigecycline showed the lowest geometric mean MIC value (0.041 mg/L), followed by fidaxomicin (0.227 mg/L), metronidazole (0.345 mg/L), and vancomycin (0.579 mg/L). About 35% of the strains (n = 35) were resistant to moxifloxacin, and the resistance rate to moxifloxacin for A-B+CDT- isolates (85.0%) was much higher than that of A+B+CDT- (15.7%) and A-B-CDT- (29.2%) isolates (P < 0.001). The MIC values of fidaxomicin, metronidazole, vancomycin and moxifloxacin against the 3 ST1 isolates were higher than for other STs. All the 28 moxifloxacin-resistant toxigenic isolates carried a mutation either in gyrA or/and gyrB. CONCLUSION: Fidaxomicin exhibited high antimicrobial activity against all C. difficile isolates tested, which shows promise as a new drug for treating Chinese CDI patients. SN - 1995-9133 UR - https://www.unboundmedicine.com/medline/citation/28693926/High_in_vitro_activity_of_fidaxomicin_against_Clostridium_difficile_isolates_from_a_university_teaching_hospital_in_China_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1684-1182(17)30120-2 DB - PRIME DP - Unbound Medicine ER -