Molecular and microbiological characterization of Clostridium difficile isolates from single, relapse, and reinfection cases.
In this study, we investigated the correlation between the microbiological characteristics of Clostridium difficile clinical isolates and the recurrence of C. difficile-associated disease (CDAD). Twenty C. difficile isolates recovered from 20 single infection cases and 53 isolates from 20 recurrent cases were analyzed by pulsed-field gel electrophoresis (PFGE) and PCR ribotyping, and the cytotoxicity, antimicrobial susceptibility, and sporulation/germination rates of the isolates were examined. Recurrent cases were divided into relapse or reinfection cases by the results of C. difficile DNA typing. Among the 20 recurrent cases, 16 cases (80%) were identified to be relapse cases caused by the initial strain and the remaining 4 cases (20%) were identified to be reinfection cases caused by different strains. All 73 isolates were susceptible to both vancomycin and metronidazole, but resistance against clindamycin, ceftriaxone, erythromycin, and ciprofloxacin was found in 87.7%, 93.2%, 87.7%, and 100% of the isolates, respectively. No correlations between DNA typing group, cytotoxicity, and sporulation rate of isolates and infection status, i.e., single, relapse, or reinfection, were observed. However, the isolates recovered from relapse cases showed a significantly higher germination rate when incubated in medium lacking the germination stimulant sodium taurocholate. These results indicate that the germination ability of C. difficile may be a potential risk factor for the recurrence of CDAD.
Department of Infectious Diseases, Kyorin University School of Medicine, Tokyo, Japan.
Kentaro
K
Oka
Takako
T
Osaki
Tomoko
T
Hanawa
Satoshi
S
Kurata
Mitsuhiro
M
Okazaki
Taki
T
Manzoku
Motomichi
M
Takahashi
Mamoru
M
Tanaka
Haruhiko
H
Taguchi
Takashi
T
Watanabe
Takashi
T
Inamatsu
Shigeru
S
Kamiya
D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001427:Bacterial Toxins / Q000633:toxicity; D016360:Clostridioides difficile / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification* / Q000472:pathogenicity; D003015:Clostridium Infections / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D006801:Humans; D008826:Microbial Sensitivity Tests; D058889:Molecular Typing; D012008:Recurrence; D021521:Ribotyping; D013171:Spores, Bacterial / Q000254:growth & development
D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins