Nontoxigenic Clostridium difficile Protects Hamsters against Challenge with Historic and Epidemic Strains of Toxigenic BI/NAP1/027 C. difficile

ABSTRACTNontoxigenicClostridium difficile(NTCD) has been shown to prevent fatalC. difficileinfection in the hamster model when hamsters are challenged with standard toxigenicC. difficilestrains. The purpose of this study was to determine if NTCD can preventC. difficileinfection in the hamster model when hamsters are challenged with restriction endonuclease analysis group BIC. difficilestrains. Groups of 10 hamsters were given oral clindamycin, followed on day 2 by 106CFU of spores of NTCD strain M3 or T7, and were challenged on day 5 with 100 CFU of spores of BI1 or BI6. To conserve animals, results for control hamsters challenged with BI1 or BI6 from the present study and controls from previous identical experiments were combined for statistical comparisons. NTCD strains M3 and T7 achieved 100% colonization and were 100% protective against challenge with BI1 (P≤ 0.001). M3 colonized 9/10 hamsters and protected against BI6 challenge in the colonized hamsters (P= 0.0003). T7 colonized 10/10 hamsters, but following BI6 challenge, cocolonization occurred in 5 hamsters, 4 of which died, for protection of 6/10 animals (P= 0.02). NTCD colonization provides protection against challenge with toxigenic BI group strains. M3 is more effective than T7 in preventingC. difficileinfection caused by the BI6 epidemic strain. Prevention ofC. difficileinfection caused by the epidemic BI6 strain may be more challenging than that of infections caused by historic BI1 and non-BIC. difficilestrains.

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Correlation between restriction endonuclease analysis and PCR ribotyping for the identification of Clostridioides (Clostridium) difficile clinical strains

Anaerobe ◽

10.1016/j.anaerobe.2018.07.004 ◽

2018 ◽

Vol 54 ◽

pp. 1-7 ◽

Cited By ~ 6

Author(s):

Larry K. Kociolek ◽

Eric R. Perdue ◽

Warren N. Fawley ◽

Mark H. Wilcox ◽

Dale N. Gerding ◽

...

Keyword(s):

Clostridium Difficile ◽

Restriction Endonuclease ◽

Restriction Endonuclease Analysis ◽

Clinical Strains ◽

Pcr Ribotyping ◽

Endonuclease Analysis

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Predominance of a Single Restriction Endonuclease Analysis Group with Intrahospital Subgroup Diversity AmongClostridium difficileIsolates at Two Chicago Hospitals

Infection Control and Hospital Epidemiology ◽

10.1086/501988 ◽

2002 ◽

Vol 23 (11) ◽

pp. 648-652 ◽

Cited By ~ 11

Author(s):

Endale T. Mekonen ◽

Dale N. Gerding ◽

Susan P. Sambol ◽

Jean M. Pottinger ◽

Joseph J. Pulvirenti ◽

...

Keyword(s):

Restriction Endonuclease ◽

Clinical Laboratory ◽

Tertiary Care ◽

Restriction Endonuclease Analysis ◽

Veterans Affairs ◽

County Hospital ◽

Analysis Group ◽

High Degree ◽

Tertiary Care Hospitals ◽

Endonuclease Analysis

Objective:To determine the epidemiology and relatedness ofClostridium difficileisolates in two geographically separated hospitals in a large metropolitan area, each with unique patients and personnel.Design:Observational descriptive molecular epidemiology of clinicalC. difficileisolates.Setting:Two tertiary-care hospitals in Chicago.Methods:ConsecutiveC. difficileisolates from the clinical laboratory of a Veterans Affairs hospital during a 13-month period were typed by restriction endonuclease analysis (REA). During an overlapping 3-month period, stool specimens that tested positive forC. difficiletoxin from patients at a nearby county hospital were cultured and the recovered isolates typed by the same method.Results:Nineteen (68%) of 28 nosocomial isolates at the smaller, Veterans Affairs hospital belonged to REA group K. Within this group of closely related strains, 9 distinct REA types were recognized. Twenty-one (72%) of 29 nosocomial isolates at the larger, county hospital also belonged to group K. However, the predominant REA types within group K differed markedly at each institution.Conclusions:These findings demonstrate a high degree of similarity among nosocomialC. difficilestrains from different hospitals in the same city and suggest the possibility of an extended outbreak of a prototype group K strain with subsequent genetic drift at the two different institutions.

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974The Clinical and Molecular Epidemiology of Pediatric Clostridium difficile Infection: Predominance of Restriction Endonuclease Analysis (REA) Group DH

Open Forum Infectious Diseases ◽

10.1093/ofid/ofu052.682 ◽

2014 ◽

Vol 1 (suppl_1) ◽

pp. S283-S284

Author(s):

Larry Kociolek ◽

Dale Gerding

Keyword(s):

Clostridium Difficile ◽

Molecular Epidemiology ◽

Restriction Endonuclease ◽

Clostridium Difficile Infection ◽

Restriction Endonuclease Analysis ◽

Endonuclease Analysis

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Fluoroquinolone and Macrolide Exposure Predict Clostridium difficile Infection with the Highly Fluoroquinolone- and Macrolide-Resistant Epidemic C. difficile Strain BI/NAP1/027

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.01820-15 ◽

2015 ◽

Vol 60 (1) ◽

pp. 418-423 ◽

Cited By ~ 28

Author(s):

Jeffrey T. Wieczorkiewicz ◽

Bert K. Lopansri ◽

Adam Cheknis ◽

James R. Osmolski ◽

David W. Hecht ◽

...

Keyword(s):

Clostridium Difficile ◽

Restriction Endonuclease Analysis ◽

First Episode ◽

Retrospective Case ◽

Content Type ◽

High Level ◽

Control Study ◽

Level Resistance ◽

Endonuclease Analysis ◽

Multiple Antibiotics

ABSTRACTAntibiotics have been shown to influence the risk of infection with specificClostridium difficilestrains as well as the risk ofC. difficileinfection (CDI). We performed a retrospective case-control study of patients infected with the epidemic BI/NAP1/027 strain in a U.S. hospital following recognition of increased CDI severity and culture of stools positive byC. difficiletoxin immunoassay. Between 2005 and 2007, 72% (103/143) of patients with first-episode CDIs were infected with the BI strain by restriction endonuclease analysis (REA) typing. Most patients received multiple antibiotics within 6 weeks of CDI onset (median of 3 antibiotic classes). By multivariate analysis, fluoroquinolone and macrolide exposure was more frequent among BI cases than among non-BI-infected controls (odds ratio [OR] for fluoroquinolones, 3.2; 95% confidence interval [CI], 1.3 to 7.5; (P< 0.001; OR for macrolides, 5.2; 95% CI, 1.1 to 24.0;P= 0.04)). In contrast, clindamycin use was less frequent among the BI cases than among the controls (OR, 0.1; 95% CI, 0.03 to 0.4;P= 0.001). High-level resistance to moxifloxacin and azithromycin was more frequent among BI strains (moxifloxacin, 49/102 [48%] BI versus 0/40 non-BI,P= 0.0001; azithromycin, 100/102 [98%] BI versus 22/40 [55%] non-BI,P= 0.0001). High-level resistance to clindamycin was more frequent among non-BI strains (22/40 [55%] non-BI versus 7/102 [7%] BI,P= 0.0001). Fluoroquinolone use, macrolide use, andC. difficileresistance to these antibiotic classes were associated with infection by the epidemic BI strain ofC. difficilein a U.S. hospital during a time when CDI rates were increasing nationally due to the highly fluoroquinolone-resistant BI/NAP1/027 strain.

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