Phenotypical and Genotypical Comparison of Clostridium difficile Isolated from Clinical Samples: Homebrew DNA Fingerprinting versus Antibiotic Susceptibility Testing (AST) and Clostridial Toxin Genes. (2nd December 2021)

• Record Type: Journal Article
• Authors: Sisakhtpour, Javid; Savaheli Moghadam, Fatemeh; Khodaparast, Sepideh; Khoramabadi, Nima; Mohabati Mobarez, Ashraf
• Other Names: Piovani Daniele Academic Editor.
• Is Part Of: Canadian journal of infectious diseases & medical microbiology =. Volume 2021(2021)
• Publication Date: 2021-12-02
• Subjects: Communicable diseases -- Periodicals; Infection -- Periodicals; Communicable diseases; Infection; Communicable Diseases; Communicable Disease Control; Electronic journals; Periodicals; Fulltext; Internet Resources; Periodicals; 616.9
• DOI: 10.1155/2021/7386554
• Languages: English
• ISSNs: 1712-9532

Abstract

Abstract : Background . Clostridium ( Clostridioides ) difficile is recognized as the major cause of healthcare antibiotic-associated diarrhea. We surveyed a molecular epidemiological correlation between the clinical isolates from two general hospitals in Iran through clustering toxigenic types and antibiotic susceptibility testing (AST) accuracy. Methods . Study population included 460 diarrhoeic specimens from inpatients with a history of antibiotic therapy. All samples underwent enriched anaerobic culture, confirmed by detection of glu D gene with PCR. Toxin status and AST were assessed by the disk diffusion method (DDM) and minimal inhibitory concentrations (MICs) of metronidazole, vancomycin, and rifampin. C. difficile outbreak was analyzed through conventional PCR by tracing toxin genes and Homebrew pulsed-field gel electrophoresis (PFGE) for characterizing isolates within our healthcare systems. Results . A total of 29 C. difficile strains were isolated by enriched anaerobic culture from the clinical samples. Among them, 22 (4.8%) toxigenic profiles yielded toxins A and B ( tcd A, tcd B) and binary toxins ( cdt A, cdt B). The minimum inhibitory concentration (MIC) was 18.1% and 9% for vancomycin and metronidazole, and all isolates were susceptible to rifampicin and its minimum inhibitory concentration was at <0.003 μ g/mL. The most dominant toxigenic and antibiotic-resistant "pulsotype F" was detected through PFGE combined with multiple Clostridial toxigenic pattern and AST. Conclusions . DNA fingerprinting studies represent a powerful tool in surveying hypervirulent C. difficile strains in clinical settings. Resistance to vancomycin and metronidazole, as first-line antibiotics, necessitate accomplishment of proper control strategies and also prescription of tigecycline as a more appropriate option.