title: Recent emergence of an epidemic clindamycin-resistant clone of Clostridium difficile among Polish patients with C. difficile-associated diarrhea.
abstract: Analysis of both the antibiotic resistance and the virulence characteristics of anaerobic human microbial pathogens is important in order to improve our understanding of a number of clinically significant infectious diseases, including Clostridium difficile-associated diarrhea (CDAD). We determined the presence of the clindamycin resistance-associated gene ermB and the ribotype of 33 C. difficile strains isolated from Polish patients suffering from CDAD. While all strains produced cytotoxin B (TcdB), enterotoxin A (TcdA) was produced by a subset of 15 strains only. The results showed that a single ermB-positive, TcdA(-)B(+) C. difficile strain with ribotype A has disseminated widely in the two Warsaw hospitals under investigation. Although different strains with the same phenotype were detected, the genotype A strain appeared to be the only one with a clear epidemic character. Apparently, enhanced local spread of CDAD-causing C. difficile may be restricted to a limited number of bacterial genotypes only.
authors.affiliation: Department of Medical Microbiology, Centre of Biostructure Research, The Medical University of Warsaw, Warsaw, Poland. hanna-pituch@ib.amwaw.edu.pl
authors.forename: Hanna
authors.initials: H
authors.lastname: Pituch
authors.forename: Alex
authors.initials: A
authors.lastname: Van Belkum
authors.forename: Nicole
authors.initials: N
authors.lastname: Van Den Braak
authors.forename: Piotr
authors.initials: P
authors.lastname: Obuch-Woszczatynski
authors.forename: Henri
authors.initials: H
authors.lastname: Verbrugh
authors.forename: Felicja
authors.initials: F
authors.lastname: Meisel-Mikołajczyk
authors.forename: Mirosław
authors.initials: M
authors.lastname: uczak
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins; D001427:Bacterial Toxins / Q000235:genetics; D002981:Clindamycin / Q000494:pharmacology*; D016360:Clostridioides difficile / Q000145:classification / Q000187:drug effects* / Q000472:pathogenicity; D003967:Diarrhea / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D004768:Enterotoxins / Q000235:genetics; D006801:Humans; D016133:Polymerase Chain Reaction; D021521:Ribotyping
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D001427:Bacterial Toxins; D004768:Enterotoxins; C041348:tcdA protein, Clostridium difficile; C031815:toxB protein, Clostridium difficile; D002981:Clindamycin