Nationwide surveillance of ribotypes and antimicrobial susceptibilities of toxigenic Clostridium difficile isolates with an emphasis on reduced doxycycline and tigecycline susceptibilities among ribotype 078 lineage isolates in Taiwan

Infection and Drug Resistance
Yuan-Pin HungWen-Chien Ko

Abstract

The information of antimicrobial susceptibility, toxin gene, and ribotype distribution of toxigenic Clostridium difficile isolates in Taiwan remain limited. The study was conducted from January 2015 to December 2016 in 5 hospitals in Taiwan. Adults aged ≥20 years with a hospital stay for >5 days were included, and those with colectomy or intestinal infection due to other enteropathogens were excluded. Multiplex PCR was used to detect tcdA, tcdB, cdtA, cdtB, and tcdC deletions, and antimicrobial susceptibility for metronidazole, vancomycin, doxycycline, and tigecycline was investigated. Ribotypes of those isolates with tcdC deletion and tcdA+/tcdB+ were determined. Of 1112 C. difficile isolates collected from adults at 5 hospitals, 842 were toxigenic, including 749 (89.0%) tcdA+/tcdB+ isolates and 93 (11.0%) tcdA-/tcdB+. Of the toxigenic isolates, 76 (9.0%) had a tcdC deletion and were cdtA+/cdtB+, indicative of hypervirulence, and RT078 lineage, including RT126, RT127, and RT078, predominated (n=53, 76.3%). Similar to the susceptibility data in Asia countries, metronidazole or vancomycin resistance was rare, noted in 1.2% or 2.1%, respectively. Reduced doxycycline susceptibility (minimum inhibitory concentration [MIC] of ≥8 mg/...Continue Reading

Citations

Aug 15, 2019·Critical Reviews in Clinical Laboratory Sciences·Jingpeng Yang, Hong Yang
Jan 2, 2019·Tropical Medicine and Infectious Disease·Deirdre A Collins, Thomas V Riley
Sep 27, 2020·Antimicrobial Resistance and Infection Control·Mohammad SholehEbrahim Kouhsari
Mar 15, 2020·Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi·Kuan-Sheng WuUNKNOWN 5th Guidelines Recommendations for Evidence-based Antimicrobial agents use in Taiwan (GREAT) working group
Mar 9, 2021·Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi·Yuan-Pin HungWen-Chien Ko
Aug 23, 2020·Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi·Jen-Chieh LeeWen-Chien Ko

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Methods Mentioned

BETA
PCR
PCRs
ribotyping
electrophoresis

Software Mentioned

SPSS

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