Recent emergence of an epidemic clindamycin-resistant clone of Clostridium difficile among Polish patients with C. difficile-associated diarrhea.
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.
Pituch
Hanna
H
Department of Medical Microbiology, Centre of Biostructure Research, The Medical University of Warsaw, Warsaw, Poland. hanna-pituch@ib.amwaw.edu.pl
Van Belkum
Alex
A
Van Den Braak
Nicole
N
Obuch-Woszczatynski
Piotr
P
Verbrugh
Henri
H
Meisel-Mikołajczyk
Felicja
F
uczak
Mirosław
M
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
D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D001427:Bacterial Toxins; D004768:Enterotoxins; C041348:tcdA protein, Clostridium difficile; C031815:toxB protein, Clostridium difficile; D002981:Clindamycin