scholarly journals Molecular characterisation of, and antimicrobial resistance in, Clostridioides difficile from Thailand, 2017-2018

2020 ◽  
Author(s):  
Korakrit Imwattana ◽  
Papanin Putsathit ◽  
Daniel R Knight ◽  
Pattarachai Kiratisin ◽  
Thomas V Riley
Keyword(s):  
Antimicrobial Resistance ◽  
Susceptibility Testing ◽  
Molecular Characterisation ◽  
Erythromycin Resistance ◽  
Penicillin Binding Proteins ◽  
Clostridioides Difficile ◽  
Pcr Ribotyping ◽  
Stool Samples ◽  
High Level ◽  
Incorporation Method

AbstractBackgroundAntimicrobial resistance (AMR) plays an important role in the pathogenesis and spread of Clostridioides difficile infection (CDI). Many antimicrobials, such as fluoroquinolones, have been associated with outbreaks of CDI globally.ObjectivesThis study aimed to characterise AMR among clinical C. difficile strains in Thailand, a country where the use of antimicrobials remains inadequately regulated.MethodsStool samples were screened for tcdB and positives were cultured. C. difficile isolates were characterised by toxin profiling and PCR ribotyping. Antimicrobial susceptibility testing was performed using an agar incorporation method, and whole-genome sequencing and AMR genotyping performed on a subset of strains.ResultsThere were 321 C. difficile strains isolated from 326 stool samples. The most common toxigenic ribotype (RT) was RT 017 (18%), followed by RTs 014 (12%) and 020 (7%). There was a high resistance prevalence (≥ 10%) to clindamycin, erythromycin, moxifloxacin and rifaximin, and resistance prevalence was greatest among RT 017 strains. AMR genotyping revealed a strong correlation between resistance genotype and phenotype for moxifloxacin and rifampicin. The presence of erm-class genes was associated with high-level clindamycin and erythromycin resistance. Point substitutions on the penicillin-binding proteins (PBP1 and PBP3) were not sufficient to confer meropenem resistance, however, a Y721S substitution in PBP3 was associated with a slight increase in meropenem MIC. No resistance to metronidazole, vancomycin or fidaxomicin was observed.ConclusionThere was a large proportion of C. difficile RT 017 in Thailand and a high AMR prevalence among these strains. The concordance between AMR phenotype and genotype was strong.

scholarly journals Prevalence and association of PCR ribotypes of Clostridium difficile isolated from symptomatic patients from Warsaw with macrolide-lincosamide-streptogramin B (MLSB) type resistance

2006 ◽  
Vol 55 (2) ◽  
pp. 207-213 ◽  
Author(s):  
Hanna Pituch ◽  
Jon S. Brazier ◽  
Piotr Obuch-Woszczatyński ◽  
Dorota Wultańska ◽  
Felicja Meisel-Mikołajczyk ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
University Hospital ◽  
Erythromycin Resistance ◽  
Toxin B ◽  
Pcr Ribotyping ◽  
Methylase Gene ◽  
High Level ◽  
The University ◽  
Antibiotic Associated Diarrhoea ◽  
Level Resistance

Isolates (79 in total) of Clostridium difficile obtained over a 2 year period from 785 patients suspected of having C. difficile-associated diarrhoea (CDAD) and being hospitalized in the University Hospital in Warsaw were characterized by toxigenicity profile and PCR ribotyping. Furthermore, their susceptibility to clindamycin and erythromycin was determined. Among the 79 C. difficile isolates, 35 were classified as A+B+, 1 as A+B+CDT+, 36 as A−B+ and 7 as A−B−. A total of 21 different PCR ribotypes was detected. Two main A+B+ strains circulated in our hospital: ribotype 014 and ribotype 046. Unexpectedly, the predominant PCR ribotype was type 017, a known A−B+ strain, and this accounted for about 45·5 % of all isolates cultured from patients with CDAD. Isolates belonging to PCR ribotype 017 were found in cases from epidemics of antibiotic-associated diarrhoea in the internal and surgery units. High-level resistance (MIC⩾256 mg l−1) to clindamycin and erythromycin was found in 39 (49 %) of the C. difficile isolates. Interestingly, 34 (94 %) of macrolide-lincosamide-streptogramin B (MLSB) type resistance strains did not produce toxin A, but produced toxin B and were A−B+ ribotype 017. Thirty-seven of the high-level resistance strains harboured the erythromycin-resistance methylase gene (ermB). C. difficile isolates (2/29) that had high-level clindamycin and erythromycin resistance, and belonged to PCR ribotype 046, were ermB negative. These investigations revealed that the predominant C. difficile strain isolated from symptomatic patients hospitalized in University Hospital in Warsaw was MLSB-positive clindamycin/erythromycin-resistant PCR ribotype 017.

scholarly journals Antimicrobial resistance surveillance in the South African private sector report for 2016

2018 ◽  
Vol 33 (4) ◽  
pp. 114-117
Author(s):  
Olga Perovic ◽  
Husna Ismail ◽  
Erika Van Schalkwyk ◽  
Warren Lowman ◽  
Elizabeth Prentice ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Private Sector ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Action Plan ◽  
Treatment Resistance ◽  
Antimicrobial Susceptibility Testing ◽  
World Health ◽  
Global Action ◽  
High Level

Aim: The relevance of surveillance for antimicrobial resistance is increasingly recognised in the light of a global action plan to combat resistance. This report presents antimicrobial susceptibility testing on ESKAPE pathogens from private sector laboratories in South Africa for 2016.Methods: Antimicrobial susceptibility testing (AST) performed on ESKAPE organisms (Enterococcus faecium, Enterococcus faecalis, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter cloacae and Escherichia coli) isolated from blood cultures at four private pathology laboratories in 2016 were analysed. Analysis and reporting of data were done via a uniform platform created by the NICD for national AST data.Results: AST were reported on 9 029 ESKAPE organisms including 58% Enterobacteriaceae, 28% Gram-positive bacteria and 14% Gram-negative bacteria and drug-bug combination was performed following the Global Antimicrobial Surveillance System (GLASS) guidelines by the World Health Organization.Conclusions: The most important resistance to address is a high level of ESBL in Enterobacteriaceae, which necessitates the use of carbapenems for treatment. Resistance to carbapenems is recorded in this report but not confirmation of genes by genotypic methods. During this period, no increase in vancomycin-resistant Enterococci was observed.

scholarly journals Antimicrobial Resistance in Salmonella Isolated from Food Workers and Chicken Products in Japan

Antibiotics ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1541
Author(s):  
Yoshimasa Sasaki ◽  
Hiromi Kakizawa ◽  
Youichi Baba ◽  
Takeshi Ito ◽  
Yukari Haremaki ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Susceptibility Testing ◽  
Bacterial Pathogen ◽  
Food Products ◽  
Generation Cephalosporin ◽  
Foodborne Illness ◽  
Third Generation ◽  
Stool Samples ◽  
Global Concern ◽  
Food Workers

Salmonella is an enteric bacterial pathogen that causes foodborne illness in humans. Third-generation cephalosporin (TGC) resistance in Salmonella remains a global concern. Food workers may represent a reservoir of Salmonella, thus potentially contaminating food products. Therefore, we aimed to investigate the prevalence of Salmonella in food workers and characterize the isolates by serotyping and antimicrobial susceptibility testing. Salmonella was isolated from 583 (0.079%) of 740,635 stool samples collected from food workers between January and December 2018, and then serotyped into 76 Salmonella enterica serovars and 22 untypeable Salmonella strains. High rates of antimicrobial resistance were observed for streptomycin (51.1%), tetracycline (33.1%), and kanamycin (18.4%). Although isolates were susceptible to ciprofloxacin, 12 (2.1%) strains (one S. Infantis, one S. Manhattan, two S. Bareilly, two S. Blockley, two S. Heidelberg, two S. Minnesota, one S. Goldcoast, and one untypeable Salmonella strain) were resistant to the TGC cefotaxime, all of which harbored β-lactamase genes (blaCMY-2, blaCTX-M-15, blaCTX-M-55, and blaTEM-52B). Moreover, 1.3% (4/309) of Salmonella strains (three S. Infantis and one S. Manhattan strains) isolated from chicken products were resistant to cefotaxime and harbored blaCMY-2 or blaTEM-52B. Thus, food workers may acquire TGC-resistant Salmonella after the ingestion of contaminated chicken products and further contaminate food products.

Prevalence, serotypes, and antimicrobial resistance of Salmonella isolates from patients with diarrhea in Shenzhen, China

2019 ◽  
Author(s):  
Hong-wei Shen ◽  
Haochuan Chen ◽  
Yongxuan Ou ◽  
Tingting Huang ◽  
Wen Ma ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Disease Burden ◽  
Antimicrobial Agents ◽  
Health Concern ◽  
Serovar Typhimurium ◽  
I 11 ◽  
Stool Samples ◽  
High Level ◽  
Rational Use Of Antibiotics ◽  
Ongoing Monitoring

Abstract Background: Salmonella is one of the main causes of diarrhea which causes substantial disease burden. To determine the prevalence, serotype distribution, and antimicrobial resistance profiles of clinical Salmonella isolates in Shenzhen, a 6-year surveillance study was conducted. Methods: Three sentinel hospitals were chosen and patients who visited the gastroenteritis clinics with acute diarrhea were enrolled. Salmonella isolates from the stool samples were subjected to serotyping, antimicrobial susceptibility testing to 24 antibiotics, and detection of resistance genes. Results: A total of 297 (5.7%) Salmonella isolates were recovered from stool samples from 5,239 patients. Among the 42 serovars identified, serovar Typhimurium was the most common serotype which represented 39.7% of the isolates (118), followed by serovar Enteritidis (71, 23.9%), London (12, 4.0%), 4, 5, 12: i: - (11, 3.7%), and Senftenberg (8, 2.7%). A high frequency of resistance was found in ampicillin (70.6%), piperacillin (64.5%), tetracycline (63.5%), and streptomycin (54.3%). Resistance to ampicillin and tetracycline was observed in 95.3% of S. Typhimurium isolates; and nalidixic acid in 93.1% of S. Enteritidis isolates. Resistance to 5 or more antimicrobial agents was identified in 78.8% of S. Typhimurium and 69.0% of S. Enteritidis isolates. Conclusions: Salmonella is an important cause of acute gastroenteritis and a broad range of serotypes are prevalent in Shenzhen, with Enteritidis and Typhimurium being the most common serovars. The high level of antibiotic resistance is a serious public health concern and ongoing monitoring coupled with rational use of antibiotics are recommended.Background: Salmonella is one of the main causes of diarrhea which causes substantial disease burden. To determine the prevalence, serotype distribution, and antimicrobial resistance profiles of clinical Salmonella isolates in Shenzhen, a 6-year surveillance study was conducted. Methods: Three sentinel hospitals were chosen and patients who visited the gastroenteritis clinics with acute diarrhea were enrolled. Salmonella isolates from the stool samples were subjected to serotyping, antimicrobial susceptibility testing to 24 antibiotics, and detection of resistance genes. Results: A total of 297 (5.7%) Salmonella isolates were recovered from stool samples from 5,239 patients. Among the 42 serovars identified, serovar Typhimurium was the most common serotype which represented 39.7% of the isolates (118), followed by serovar Enteritidis (71, 23.9%), London (12, 4.0%), 4, 5, 12: i: - (11, 3.7%), and Senftenberg (8, 2.7%). A high frequency of resistance was found in ampicillin (70.6%), piperacillin (64.5%), tetracycline (63.5%), and streptomycin (54.3%). Resistance to ampicillin and tetracycline was observed in 95.3% of S. Typhimurium isolates; and nalidixic acid in 93.1% of S. Enteritidis isolates. Resistance to 5 or more antimicrobial agents was identified in 78.8% of S. Typhimurium and 69.0% of S. Enteritidis isolates. Conclusions: Salmonella is an important cause of acute gastroenteritis and a broad range of serotypes are prevalent in Shenzhen, with Enteritidis and Typhimurium being the most common serovars. The high level of antibiotic resistance is a serious public health concern and ongoing monitoring coupled with rational use of antibiotics are recommended.

scholarly journals The changes of PCR ribotype and antimicrobial resistance of Clostridium difficile in a tertiary care hospital over 10 years

2014 ◽  
Vol 63 (6) ◽  
pp. 819-823 ◽  
Author(s):  
Jong-Han Lee ◽  
Yangsoon Lee ◽  
Kyungwon Lee ◽  
Thomas V. Riley ◽  
Heejung Kim
Keyword(s):  
Amino Acid ◽  
Clostridium Difficile ◽  
Antimicrobial Resistance ◽  
Susceptibility Testing ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Dna Gyrase ◽  
Care Hospital ◽  
Pcr Ribotyping ◽  
Resistance Rates

The aims of this study were to investigate any change in PCR ribotypes and to determine the antimicrobial resistance of common PCR ribotypes over a 10-year period in a tertiary care hospital. We conducted PCR ribotyping, antimicrobial susceptibility testing and DNA gyrase sequencing to identify changes in 1407 Clostridium difficile non-duplicated isolates obtained between 2000 and 2009. A total of 74 different ribotypes were found. The most prevalent ribotype was ribotype 001 (26.1 %). The prevalence of ribotype 017 was 17 % and that of ribotype 014/020 was 9.6 %. Ribotyping showed that the prevalence of ribotype 001 decreased and the prevalence of ribotypes 017, 014/020 and 018 increased over the 10 years. Antimicrobial resistance rates in prevalent ribotypes were: clindamycin, 81 %; cefotetan, 19 %; moxifloxacin, 42 %; imipenem, 8 %; ciprofloxacin, 100 % and erythromycin, 80 %. Ribotype 018 showed greater antimicrobial resistance than other ribotypes. All ribotype 018 strains showing moxifloxacin resistance had a substitution of a gyrA coding amino acid (Thr82 to Ile). This study will help the understanding of PCR ribotype trends and antimicrobial resistance of C. difficile in Korea.

scholarly journals Antimicrobial Resistance Patterns in Clostridioides difficile Strains Isolated from Neonates in Germany

Antibiotics ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 481
Author(s):  
Friederike K. M. T. Tilkorn ◽  
Hagen Frickmann ◽  
Isabel S. Simon ◽  
Julian Schwanbeck ◽  
Sebastian Horn ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Longitudinal Survey ◽  
Resistance Testing ◽  
Clostridioides Difficile ◽  
Initial Cohort ◽  
Resistance Patterns ◽  
Stool Samples ◽  
Toxigenic Strains ◽  
Moderate Resistance ◽  
Selection Of

Young children are frequently colonized with Clostridioides (C.) difficile. Depending on their resistance patterns, antibiotic treatment can facilitate gastrointestinal spreading in colonized individuals, potentially leading to transmission to others. C. difficile was isolated from stool samples from infants born in two hospitals in Göttingen and Darmstadt, Germany. All isolates were subjected to phenotypic antimicrobial resistance testing, PCR-based screening for toxin genes and mass spectrometry-based exclusion of ribotypes 027 and 176. Within an initial cohort of 324 neonates with a longitudinal survey of C. difficile, 137 strains were isolated from 48 individuals. Antimicrobial resistance was recorded against metronidazole in one (0.7%), erythromycin in 16 (11.7%) and moxifloxacin in 2 (1.5%) of the strains, whereas no resistance was observed against vancomycin (0.0%) or rifampicin (0.0%). Newly observed resistance against erythromycin in children with detection of previously completely sensitive isolates was reported for C. difficile isolates from 2 out of 48 children. In 20 children (42%), non-toxigenic strains were detected, and from 27 children (56%), toxigenic strains were isolated, while both toxigenic and non-toxigenic strains were recorded for 1 child (2%). Ribotypes 027 or 176 were not observed. In conclusion, the German C. difficile strains isolated from the children showed mild to moderate resistance with predominance of macrolide resistance, a substance class which is frequently applied in children. The observed switches to the dominance of macrolide-resistant isolates suggests likely selection of resistant C. difficile strains already in children.

scholarly journals Antimicrobial resistance of Neisseria gonorrhoeae isolates in south-west Germany, 2004 to 2015: increasing minimal inhibitory concentrations of tetracycline but no resistance to third-generation cephalosporins

2016 ◽  
Vol 21 (36) ◽  
Author(s):  
Thomas Regnath ◽  
Thomas Mertes ◽  
Ralf Ignatius
Keyword(s):  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Susceptibility Testing ◽  
West Germany ◽  
Third Generation ◽  
Minimal Inhibitory Concentrations ◽  
South West ◽  
Male Patients ◽  
High Level ◽  
Third Generation Cephalosporins

Increasing antimicrobial resistance of Neisseria gonorrhoeae, particularly to third-generation cephalosporins, has been reported in many countries. We examined the susceptibility (determined by Etest and evaluated using the breakpoints of the European Committee on Antimicrobial Susceptibility Testing) of 434 N. gonorrhoeae isolates collected from 107 female and 327 male patients in Stuttgart, south-west Germany, between 2004 and 2015. During the study period, high proportions of isolates were resistant to ciprofloxacin (70.3%), tetracycline (48.4%; increasing from 27.5% in 2004/2005 to 57.7% in 2014/2015; p = 0.0002) and penicillin (25.6%). The proportion of isolates resistant to azithromycin was low (5.5%) but tended to increase (p = 0.08). No resistance and stable minimum inhibitory concentrations were found for cefixime, ceftriaxone, and spectinomycin. High-level resistance was found for ciprofloxacin (39.6%) and tetracycline (20.0%) but not for azithromycin; 16.3% of the isolates produced betalactamase. Thus, cephalosporins can still be used for the treatment of gonorrhoea in the study area. To avoid further increasing resistance to azithromycin, its usage should be limited to patients allergic to cephalosporins, or (in combination with cephalosporins) to patients for whom no susceptibility testing could be performed or those co-infected with chlamydiae.

scholarly journals Toxin gene profiles and antimicrobial resistance of Clostridioides difficile infection: a single tertiary care center study in Iran

2021 ◽  
Author(s):  
Mohammad Sholeh ◽  
Ebrahim Kouhsari ◽  
Malihe Talebi ◽  
Masoumeh Hallajzadeh ◽  
Forough Godarzi ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Biotic Resistance ◽  
Hospitalized Patients ◽  
Toxin Gene ◽  
Gene Profile ◽  
Clostridioides Difficile ◽  
Gene Profiles ◽  
Antibiotic Susceptibility Test ◽  
Clostridioides Difficile Infection ◽  
Stool Samples

Background and Objectives: Due to the reduced susceptibility of clinical Clostridioides difficile strains in hospitals to var- ious antimicrobial agents, the importance of antimicrobial susceptibility testing (ASTs) has increased. This study aimed to investigate the toxin gene profiles and the antimicrobial resistance of C. difficile isolated from hospitalized patients suspected of having Clostridioides difficile infection (CDI) in Tehran, Iran. Materials and Methods: The stool samples were obtained from a hospitalized patients. The samples were shocked by al- cohol and the patients cultured on cycloserine-cefoxitin-fructose agar in anaerobic Conditions. Toxin assay was performed for detection of toxinogenic isolates. An antibiotic susceptibility test was done. Furthermore, their genome was extracted for PCR to confirm C. difficile and detect toxin gene profile. Results: Toxigenic C. difficile were identified in 21 of the 185 stool samples (11.3%). PCR detected seven toxin gene profiles; the highest prevalence was related to tcdA+B+, cdtA+B-  toxin gene profile (57.1%). There were 14.3% and 28.6% resistant rates of the isolates towards vancomycin and metronidazole with the toxin gene profiles; tcdA+B+, cdtA±B+; and tc- dA+B-, cdtA-B+. All resistant isolates to moxifloxacin, clindamycin, and tetracycline were belonged to the toxin gene profiles; tcdA+B+, cdtA+B+; tcdA+B+, cdtA+B-, and tcdA-B+, cdtA+B-. Conclusion: Relative high resistance was detected towards metronidazole and vancomycin, although, still have acceptable activity for CDI treatment. However, a proper plan for the use of antibiotics and more regular screening of C. difficile anti- biotic resistance seems necessary.

scholarly journals An Outbreak of Clostridium (Clostridioides) difficile Infections within an Acute and Long-Term Care Wards Due to Moxifloxacin-Resistant PCR Ribotype 176 Genotyped as PCR Ribotype 027 by a Commercial Assay

2020 ◽  
Vol 9 (11) ◽  
pp. 3738
Author(s):  
Elena Novakova ◽  
Nina Kotlebova ◽  
Anezka Gryndlerova ◽  
Martin Novak ◽  
Michala Vladarova ◽  
...  
Keyword(s):  
Tandem Repeats ◽  
Long Term Care ◽  
Variable Number ◽  
Term Care ◽  
Clostridioides Difficile ◽  
Commercial Assay ◽  
Pcr Ribotyping ◽  
Stool Samples ◽  
Variable Number Tandem Repeats

We aimed to characterize Clostridioides difficile isolates cultured during a six-month single-center study from stool samples of patients with C. difficile infection (CDI) genotyped by the Xpert®C. difficile/Epi assay by polymerase chain reaction (PCR) ribotyping, toxin genes’ detection and multi-locus variable number tandem repeats analysis (MLVA). The susceptibility to metronidazole, vancomycin and moxifloxacin was determined by agar dilution. In addition, the presence of Thr82Ile in the GyrA and a single nucleotide deletion at position (Δ117) in the tcdC gene were investigated. Between January 1 and June 30, 2016, of 114 CDIs, 75 cases were genotyped as presumptive PCR ribotype (RT) 027 infections using a commercial assay. C. difficile isolates cultured from presumptive RT027 stool samples belonged to RT176. These isolates carried genes for toxin A (tcdA), B (tcdB), binary (cdtA/B) and had Δ117 in the tcdC gene. Using MLVA, the 71/75 isolates clustered into two clonal complexes (CCs). Of these, 39 isolates (54.9%) were from patients hospitalized in acute care and 32 isolates (45.1%) were isolated from patients hospitalized in the long-term care department. All isolates were susceptible to metronidazole and vancomycin, and 105 isolates were resistant to moxifloxacin (92%) carrying Thr83Ile in the GyrA. An outbreak of RT176 CDIs, suspected as RT027, was recognized in a Slovakian hospital. In order to monitor the emergence and spread of RT027-variants, the identification of a presumptive RT027 CDI should be confirmed at a strain level by PCR ribotyping.

scholarly journals Trends in antimicrobial resistance in Europe: report from EARSS

2004 ◽  
Vol 8 (51) ◽  
Author(s):  
N Bruinsma ◽  
Collective EARSS
Keyword(s):  
Streptococcus Pneumoniae ◽  
Antimicrobial Resistance ◽  
Erythromycin Resistance ◽  
The Past ◽  
High Level

In Europe, the proportion of erythromycin resistance among invasive Streptococcus pneumoniae isolates has remained at a high level over the past few years

Sign in / Sign up

Export Citation Format

Share Document