title: Assessment of changes in the epidemiology of Clostridium difficile isolated from diarrheal patients in Hungary.
abstract: 150 Clostridium difficile strains isolated from diarrheal feces were collected from three parts of Hungary and the presence of genes responsible for toxin A and B, and binary toxin production were examined. MIC distribution against clindamycin, erythromycin, metronidazole, moxifloxacin and rifampin of 80 toxigenic strains selected from the above-mentioned strains and 20 large clostridial toxins (LCTs)-positive strains chosen from our earlier strain collection were determined. 80% of the examined 150 strains were positive for both tcdA and tcdB, and no toxin A-negative, toxin B-positive isolates were found during the study period. 5.3% of toxigenic strains proved to be positive for binary toxin too. Among binary toxin-positive strains, one strain showed the same pattern characteristic of PCR ribotype 027. Comparison of recent findings and our earlier results, the prevalence of toxin-producing and binary toxin-positive strains among C. difficile isolated from diarrheal specimens increased. No metronidazole resistant isolate was detected among strains isolated in 2002-2003 and 2006-2007. The rates of resistance to erythromycin, clindamycin, moxifloxacin and rifampin among strains isolated between 2006 and 2007 were 25%, 27.5%, 25% and 6.3%, respectively. Erythromycin resistance was frequently associated with clindamycin and moxifloxacin resistance, however this resistant phenotype was not found among strains isolated in 2002-2003.
authors.affiliation: Institute of Clinical Microbiology, Faculty of Medicine, University of Szeged, H-6725 Szeged, Semmelweis u 6, Hungary. terhesga@freemail.hu
authors.forename: Gabriella
authors.initials: G
authors.lastname: Terhes
authors.forename: Edit
authors.initials: E
authors.lastname: Urbán
authors.forename: József
authors.initials: J
authors.lastname: Sóki
authors.forename: Lenke
authors.initials: L
authors.lastname: Szikra
authors.forename: Marianne
authors.initials: M
authors.lastname: Konkoly-Thege
authors.forename: Mária
authors.initials: M
authors.lastname: Vollain
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Nagy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics / Q000378:metabolism; D001427:Bacterial Toxins / Q000235:genetics / Q000378:metabolism; D016360:Clostridioides difficile / Q000145:classification* / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D003967:Diarrhea / Q000453:epidemiology* / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D004761:Enterocolitis, Pseudomembranous / Q000453:epidemiology* / Q000382:microbiology; D004768:Enterotoxins / Q000235:genetics / Q000378:metabolism; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D017720:Molecular Epidemiology; 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