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Prevalence, genetic relatedness and antibiotic resistance of hospital-acquired clostridium difficile PCR ribotype 018 strains

Title
Prevalence, genetic relatedness and antibiotic resistance of hospital-acquired clostridium difficile PCR ribotype 018 strains
Author
김지은
Keywords
Clostridium difficile; PCR ribotype 018; MLVA; Antimicrobials; Minimum inhibitory concentration
Issue Date
2018-03
Publisher
ELSEVIER SCIENCE BV
Citation
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, v. 51, no. 5, page. 762-767
Abstract
Clostridium difficile infection (CDI) is a major healthcare-associated infection. The aim of this study was to investigate the genetic relatedness of the endemic C. difficile PCR ribotype 018 strains in an institution and changes to their characteristics during a five-year period.A total of 207 isolates from inpatients at Hanyang University Hospital from 2009 to 2013 were analysed using multilocus variable-number tandem-repeat analysis (MLVA). Minimum inhibitory concentrations (MICs) of several antibiotics were determined.In total, 204 (98.6%) were genetically related, with a summed tandem-repeat distance (STRD) <= 10. Minimum-spanning-tree analysis identified 78 MLVA types, categorized into six clonal complexes (CCs). The largest cluster, CC-I, included 51 MLVA types from 148 isolates (71.5%) and the second largest cluster, CC-II, included 10 MLVA types from 36 isolates (17.4%). Resistance rates for antibiotics were: clindamycin (CLI), 97.6%; moxifloxacin (MXF), 98.6%; vancomycin (VAN), 1.4%; and rifaximin (RFX), 8.2%. All isolates were susceptible to piperacillin/tazobactam (TZP) and metronidazole (MTZ). Comparing the MICs of antibiotics for the isolates each year from 2009 to 2013, MICs of antibiotics that promote CDI, such as CLI, MXF, TZP and RFX, increased over the five-year period (P-value by Kruskal-Wallis test: <0.0001, <0.0001, <0.0001, and <0.0001 respectively); however, MICs of VAN or MTZ, antibiotics for treatment of CDI, did not increase or decreased over the same time period (P-value by Kruskal-Wallis test: 0.166, <0.0001).C. difficile RT018 isolates in a tertiary hospital over a five-year period presented a close clonal relationship. MICs of antibiotics promoting CDI increased with this clonal expansion. (c) 2018 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.
URI
https://www.sciencedirect.com/science/article/abs/pii/S0924857918300360?via%3Dihubhttp://repository.hanyang.ac.kr/handle/20.500.11754/117986
ISSN
0924-8579; 1872-7913
DOI
10.1016/j.ijantimicag.2018.01.025
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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