title: Molecular epidemiology and susceptibility profiles of Clostridium difficile in New Zealand, 2009.
abstract: OBJECTIVE
  The aim of this study was to provide baseline information on the molecular epidemiology and the antimicrobial susceptibility of Clostridium difficile (C. difficile) clinical isolates from patients throughout New Zealand.
  
  
  METHODS
  Faecal specimens that were C. difficile-toxin positive by EIA assay were cultured for C. difficile. Antimicrobial susceptibility testing was carried out using the agar dilution minimum inhibitory concentration method. The following antibiotics were tested: penicillin, piperacillin/tazobactam, vancomycin, ciprofloxacin, moxifloxacin, clindamycin, clarithromycin, meropenem and metronidazole. Molecular typing by PCR-ribotyping was performed on all isolates.
  
  
  RESULTS
  C. difficile was isolated from 108 of 159 submitted faecal specimens. After excluding the repeats, there were 101 isolates from 97 patients. Most isolates were fully susceptible to the range of antibiotics tested. Thirty-two PCR-ribotypes were identified among the 101 isolates. The most common ribotypes were 014 (18 isolates), 002 (11) and 005 (10). No PCR-ribotype 027 isolates were identified, but one isolate of another hypervirulent strain, PCR-ribotype 078, was identified.
  
  
  CONCLUSIONS
  There is a wide range of C. difficile PCR-ribotypes circulating in New Zealand and antimicrobial resistance is uncommon. Ongoing surveillance for hypervirulent strains of C. difficile is essential to prevent the dissemination of these strains within New Zealand hospitals.
authors: Department of Microbiology, LabPlus, Auckland District Health Board, Grafton, Auckland, New Zealand. sallyrob@adhb.govt.nz
authors: Sally
authors: S
authors: Roberts
authors: Helen
authors: H
authors: Heffernan
authors: Nadia
authors: N
authors: Al Anbuky
authors: Christopher
authors: C
authors: Pope
authors: Susan
authors: S
authors: Paviour
authors: Tracey
authors: T
authors: Camp
authors: Terri
authors: T
authors: Swager
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016360:Clostridioides difficile / Q000187:drug effects* / Q000235:genetics*; D003428:Cross Infection / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology*; D004761:Enterocolitis, Pseudomembranous / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology*; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009520:New Zealand; D016133:Polymerase Chain Reaction; D011159:Population Surveillance; D021521:Ribotyping; D014774:Virulence / Q000187:drug effects / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents