title: Molecular characterization and antimicrobial susceptibilities of extra-intestinal Clostridium difficile isolates.
abstract: Amongst 25 extra-intestinal clinical isolates of Clostridium difficile, A(+)B(+) (72%) and A(-)B(+) (4%) toxigenic phenotypes, as well as the non-toxigenic phenotype (A(-)B(-)) (24%), were identified. The A(-)B(-) isolates did not express toxin, yet carried part of the tcdA and tcdB gene and are of a previously unreported toxinotype. Six A(+)B(+) isolates also carried binary toxin genes. Resistance to erythromycin (20%), clindamycin (48%), tetracycline (16%), moxifloxacin (16%) and imipenem (11%) occurred but with no apparent correlation to phenotype. None of the strains was resistant to vancomycin or metronidazole. Imipenem-resistance decreased by EDTA, but susceptibility to meropenem suggests the presence of an imipenem specific metalloenzyme.
authors.affiliation: TechLab, Inc., 2001 Kraft Drive, Blacksburg, VA 24060, USA. zhengl@techlab.com
authors.forename: Limin
authors.initials: L
authors.lastname: Zheng
authors.forename: Diane M
authors.initials: DM
authors.lastname: Citron
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Genheimer
authors.forename: Stephanie F
authors.initials: SF
authors.lastname: Sigmon
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Carman
authors.forename: David M
authors.initials: DM
authors.lastname: Lyerly
authors.forename: Ellie J C
authors.initials: EJ
authors.lastname: Goldstein
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics*; D001427:Bacterial Toxins / Q000235:genetics*; D016360:Clostridioides difficile / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity*; D003015:Clostridium Infections / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D004768:Enterotoxins / Q000235:genetics*; D006801:Humans; D007422:Intestines / Q000382:microbiology*; D008826:Microbial Sensitivity Tests; D010641:Phenotype
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D001427:Bacterial Toxins; D004768:Enterotoxins; C041348:tcdA protein, Clostridium difficile; C031815:toxB protein, Clostridium difficile