1887

Abstract

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 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 coding amino acid (Thr82 to Ile). This study will help the understanding of PCR ribotype trends and antimicrobial resistance of in Korea.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.072082-0
2014-06-01
2021-03-07
Loading full text...

Full text loading...

/deliver/fulltext/jmm/63/6/819.html?itemId=/content/journal/jmm/10.1099/jmm.0.072082-0&mimeType=html&fmt=ahah

References

  1. Ackermann G., Tang Y. J., Kueper R., Heisig P., Rodloff A. C., Silva J. Jr, Cohen S. H. 2001; Resistance to moxifloxacin in toxigenic Clostridium difficile isolates is associated with mutations in gyrA. Antimicrob Agents Chemother 45:2348–2353 [CrossRef][PubMed]
    [Google Scholar]
  2. Ackermann G., Degner A., Cohen S. H., Silva J. Jr, Rodloff A. C. 2003; Prevalence and association of macrolide-lincosamide-streptogramin B (MLSB) resistance with resistance to moxifloxacin in Clostridium difficile. J Antimicrob Chemother 51:599–603 [CrossRef][PubMed]
    [Google Scholar]
  3. Barbut F., Decré D., Lalande V., Burghoffer B., Noussair L., Gigandon A., Espinasse F., Raskine L., Robert J.& other authors ( 2005; Clinical features of Clostridium difficile-associated diarrhoea due to binary toxin (actin-specific ADP-ribosyltransferase)-producing strains. J Med Microbiol 54:181–185 [CrossRef][PubMed]
    [Google Scholar]
  4. Barbut F., Mastrantonio P., Delmée M., Brazier J., Kuijper E., Poxton I.European Study Group on Clostridium difficile (ESGCD) 2007; Prospective study of Clostridium difficile infections in Europe with phenotypic and genotypic characterisation of the isolates. Clin Microbiol Infect 13:1048–1057 [CrossRef][PubMed]
    [Google Scholar]
  5. Bauer M. P., Notermans D. W., van Benthem B. H., Brazier J. S., Wilcox M. H., Rupnik M., Monnet D. L., van Dissel J. T., Kuijper E. J.ECDIS Study Group 2011; Clostridium difficile infection in Europe: a hospital-based survey. Lancet 377:63–73 [CrossRef][PubMed]
    [Google Scholar]
  6. Bourgault A. M., Lamothe F., Loo V. G., Poirier L.CDAD-CSI Study Group 2006; In vitro susceptibility of Clostridium difficile clinical isolates from a multi-institutional outbreak in Southern Québec, Canada. Antimicrob Agents Chemother 50:3473–3475 [CrossRef][PubMed]
    [Google Scholar]
  7. Cheknis A. K., Zukowski W. E., Petrella A. K., Nagaro J., Sambol S. P., Figueroa I., Li L.Q., Perdue E., Gelone S. P. other authors 2009; Prevalence of REA types of Clostridium difficile from U.S. hospitals (2006–2009). In Abstracts of the 49th Interscience Conference on Antimicrobial Agents and Chemotherapy abstract K-2075 San Francisco, CA:
  8. CLSI 2012; Methods for Antimicrobial Susceptibility Testing of Anaerobic Bacteria; Approved Standard M11–A8. Wayne, PA: Clinical and Laboratory Standards Institute;
  9. CLSI 2013; Performance Standards for Antimicrobial Susceptibility Testing; 23rd Informational Supplement M100–S23. Wayne, PA: Clinical and Laboratory Standards Institute;
  10. Dridi L., Tankovic J., Burghoffer B., Barbut F., Petit J. C. 2002; gyrA and gyrB mutations are implicated in cross-resistance to ciprofloxacin and moxifloxacin in Clostridium difficile. Antimicrob Agents Chemother 46:3418–3421 [CrossRef][PubMed]
    [Google Scholar]
  11. Drudy D., Quinn T., O’Mahony R., Kyne L., O’Gaora P., Fanning S. 2006; High-level resistance to moxifloxacin and gatifloxacin associated with a novel mutation in gyrB in toxin-A-negative, toxin-B-positive Clostridium difficile. J Antimicrob Chemother 58:1264–1267 [CrossRef][PubMed]
    [Google Scholar]
  12. Heddle J., Maxwell A. 2002; Quinolone-binding pocket of DNA gyrase: role of GyrB. Antimicrob Agents Chemother 46:1805–1815 [CrossRef][PubMed]
    [Google Scholar]
  13. Huang H., Fang H., Weintraub A., Nord C. E. 2009a; Distinct ribotypes and rates of antimicrobial drug resistance in Clostridium difficile from Shanghai and Stockholm. Clin Microbiol Infect 15:1170–1173 [CrossRef][PubMed]
    [Google Scholar]
  14. Huang H., Weintraub A., Fang H., Nord C. E. 2009b; Antimicrobial resistance in Clostridium difficile. Int J Antimicrob Agents 34:516–522 [CrossRef][PubMed]
    [Google Scholar]
  15. Huang H., Wu S., Wang M., Zhang Y., Fang H., Palmgren A. C., Weintraub A., Nord C. E. 2009c; Clostridium difficile infections in a Shanghai hospital: antimicrobial resistance, toxin profiles and ribotypes. Int J Antimicrob Agents 33:339–342 [CrossRef][PubMed]
    [Google Scholar]
  16. Kato H., Kato N., Watanabe K., Iwai N., Nakamura H., Yamamoto T., Suzuki K., Kim S. M., Chong Y., Wasito E. B. 1998; Identification of toxin A-negative, toxin B-positive Clostridium difficile by PCR. J Clin Microbiol 36:2178–2182[PubMed]
    [Google Scholar]
  17. Kim H., Jeong S. H., Roh K. H., Hong S. G., Kim J. W., Shin M. G., Kim M. N., Shin H. B., Uh Y.& other authors ( 2010; Investigation of toxin gene diversity, molecular epidemiology, and antimicrobial resistance of Clostridium difficile isolated from 12 hospitals in South Korea. Korean J Lab Med 30:491–497 [CrossRef][PubMed]
    [Google Scholar]
  18. Lyerly D. M., Krivan H. C., Wilkins T. D. 1988; Clostridium difficile: its disease and toxins. Clin Microbiol Rev 1:1–18[PubMed]
    [Google Scholar]
  19. McDonald L. C., Killgore G. E., Thompson A., Owens R. C. Jr, Kazakova S. V., Sambol S. P., Johnson S., Gerding D. N. 2005; An epidemic, toxin gene-variant strain of Clostridium difficile. N Engl J Med 353:2433–2441 [CrossRef][PubMed]
    [Google Scholar]
  20. O’Donoghue C., Kyne L. 2011; Update on Clostridium difficile infection. Curr Opin Gastroenterol 27:38–47 [CrossRef][PubMed]
    [Google Scholar]
  21. Sawabe E., Kato H., Osawa K., Chida T., Tojo N., Arakawa Y., Okamura N. 2007; Molecular analysis of Clostridium difficile at a university teaching hospital in Japan: a shift in the predominant type over a five-year period. Eur J Clin Microbiol Infect Dis 26:695–703 [CrossRef][PubMed]
    [Google Scholar]
  22. Spigaglia P., Barbanti F., Mastrantonio P., Brazier J. S., Barbut F., Delmée M., Kuijper E., Poxton I. R.European Study Group on Clostridium difficile (ESGCD) 2008; Fluoroquinolone resistance in Clostridium difficile isolates from a prospective study of C. difficile infections in Europe. J Med Microbiol 57:784–789 [CrossRef][PubMed]
    [Google Scholar]
  23. Spigaglia P., Barbanti F., Dionisi A. M., Mastrantonio P. 2010; Clostridium difficile isolates resistant to fluoroquinolones in Italy: emergence of PCR ribotype 018. J Clin Microbiol 48:2892–2896 [CrossRef][PubMed]
    [Google Scholar]
  24. Stubbs S. L., Brazier J. S., O’Neill G. L., Duerden B. I. 1999; PCR targeted to the 16S-23S rRNA gene intergenic spacer region of Clostridium difficile and construction of a library consisting of 116 different PCR ribotypes. J Clin Microbiol 37:461–463[PubMed]
    [Google Scholar]
  25. Stubbs S., Rupnik M., Gibert M., Brazier J., Duerden B., Popoff M. 2000; Production of actin-specific ADP-ribosyltransferase (binary toxin) by strains of Clostridium difficile. FEMS Microbiol Lett 186:307–312 [CrossRef][PubMed]
    [Google Scholar]
  26. Tae C. H., Jung S. A., Song H. J., Kim S. E., Choi H. J., Lee M., Hwang Y., Kim H., Lee K. 2009; The first case of antibiotic-associated colitis by Clostridium difficile PCR ribotype 027 in Korea. J Korean Med Sci 24:520–524 [CrossRef][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.072082-0
Loading
/content/journal/jmm/10.1099/jmm.0.072082-0
Loading

Data & Media loading...

Most cited this month Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error