New PCR ribotypes of Clostridium difficile detected in children in Brazil: prevalent types of Clostridium difficile in Brazil.
A total of 35 Brazilian isolates of Clostridium difficile from faecal stools and four isolates from hospital environments were analyzed by PCR ribotyping. A whole cell protein profile (as an alternative for serogrouping), in vitro toxin production and susceptibility to vancomycin, metronidazole and clindamycin were also investigated. All strains were typeable by both phenotypic and genotypic methods, and a total of 13 different PCR ribotypes were identified, of which seven (132, 133, 134, 135, 136, 142 and 143) were considered new types and accounted for 78.5% of all samples evaluated (including hospital environments). A non-toxigenic C. difficile PCR ribotype 133 was detected in all children groups examined (inpatients, outpatients and healthy children), whilst toxigenic PCR ribotypes 015, 131, 134 and 135 were associated mostly with symptomatic children. Serogroups G and D were disseminated both in patients from the community and from the pediatric hospital, with group G prevalent among outpatient children. All strains were susceptible to vancomycin and metronidazole but high levels of resistance to clindamycin were found, especially among serogroups G and D. Co-existence of different ribotypes and serogroups in the same individual was observed. The new seven ribotypes found in this investigation may represent strains characteristic of this region of Brazil.
Alcides
Ana P P
AP
Instituto de Microbiologia Prof. Paulo de Góes, UFRJ, Rio de Janeiro, RJ, Brazil.
Brazier
Jon S
JS
Pinto
Leandro J F
LJ
Balassiano
Ilana T
IT
Boente
Renata F
RF
de Paula
Geraldo R
GR
Ferreira
Eliane O
EO
Avelar
Kátia E S
KE
Miranda
Karla R
KR
Ferreira
M Candida S
MC
Domingues
Regina M C P
RM
D001938:Brazil; D002648:Child; D002675:Child, Preschool; D002981:Clindamycin / Q000494:pharmacology; D016360:Clostridioides difficile / Q000145:classification / Q000187:drug effects / Q000235:genetics*; D004591:Electrophoresis, Polyacrylamide Gel; D004761:Enterocolitis, Pseudomembranous / Q000382:microbiology*; D006801:Humans; D007223:Infant; D008795:Metronidazole / Q000494:pharmacology; D008826:Microbial Sensitivity Tests; D016133:Polymerase Chain Reaction; D021521:Ribotyping / Q000379:methods*; D014640:Vancomycin / Q000494:pharmacology
D008795:Metronidazole; D002981:Clindamycin; D014640:Vancomycin