Clostridium difficile is the etiological agent of diarrhoea and colitis, especially in elderly patients. The incidence of these diseases has increased during the last 10 years. Emergence of so-called hypervirulent strains is considered as one of the main factors responsible for the more severe disease and changed profile of sensitivity to antimicrobial agents. The aim of this work was to determine the sensitivity profile of toxigenic strains of C. difficile in the Czech Republic in 2011-2012 to selected antibiotics. The antibiotics clindamycin, metronidazole, vancomycin and amoxicillin with clavulanic acid were used for this purpose. Isolates cultured on Brazier's C. difficile selective agar were analysed for the presence of toxin genes using Xpert detection system. Xpert analysis revealed that 33 strains carried the genes for toxins tcdB, cdt and tcdCΔ117, thus showing characteristics typical for the hypervirulent ribotype 027/PFGE type NAP1/REA type B1. The remaining 29 strains carried only the gene for toxin B (tcdB) and not cdt and tcdCΔ117. Our results indicate the higher susceptibility of C. difficile hypertoxigenic strains to three out of four tested antibiotics (except vancomycin) than it is for the other toxigenic strains. We found that only 10.34% of other toxigenic strains were resistant to clindamycin, and no resistance was found in all other cases. All the isolates were sensitive to amoxicillin/clavulanic acid in vitro. However, its use is not recommended for therapy of infections caused by C. difficile.

Czech Anaerobic Bacteria Reference Laboratory Institute of Microbiology and Immunology Faculty of Medicine University of Ostrava Syllabova 19 703 00 Ostrava Czech Republic

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N Engl J Med. 2002 Jan 31;346(5):334-9 PubMed

J Antimicrob Chemother. 2011 Oct;66(10):2227-34 PubMed

Anaerobe. 2009 Dec;15(6):234-6 PubMed

Anaerobe. 2009 Dec;15(6):256-60 PubMed

Microbiology (Reading). 2001 Feb;147(Pt 2):439-447 PubMed

Lancet. 2011 Apr 23;377(9775):1407 PubMed

Infect Med. 2009;26(7):211-220 PubMed

Nat Rev Microbiol. 2009 Jul;7(7):526-36 PubMed

Clin Microbiol Infect. 2010 Aug;16(8):1104-10 PubMed

J Med Microbiol. 2012 Jan;61(Pt 1):49-56 PubMed

J Antimicrob Chemother. 2011 Sep;66(9):1976-82 PubMed

Infect Control Hosp Epidemiol. 2009 Jun;30(6):518-25 PubMed

Antimicrob Agents Chemother. 2012 Sep;56(9):4786-92 PubMed

J Hosp Infect. 2005 Sep;61(1):11-4 PubMed

Methods Mol Biol. 2009;551:159-71 PubMed

J Antimicrob Chemother. 2009 Mar;63(3):520-5 PubMed

J Infect. 2011 Apr;62(4):271-9 PubMed

J Clin Microbiol. 2006 Feb;44(2):353-8 PubMed

J Clin Microbiol. 2008 Sep;46(9):3028-32 PubMed

Anaerobe. 2012 Aug;18(4):414-6 PubMed

Lancet. 2005 Sep 24-30;366(9491):1079-84 PubMed

Anaerobe. 2010 Dec;16(6):633-5 PubMed

J Antimicrob Chemother. 2012 Oct;67(10):2434-7 PubMed

J Med Microbiol. 2010 Mar;59(Pt 3):338-344 PubMed

Emerg Infect Dis. 2006 Mar;12(3):409-15 PubMed

J Antimicrob Chemother. 2008 Oct;62(4):762-5 PubMed

Klin Mikrobiol Infekc Lek. 2011 Dec;17(6):208-13 PubMed

Clin Microbiol Infect. 2008 May;14 Suppl 5:2-20 PubMed

Int J Antimicrob Agents. 2012 Jul;40(1):24-9 PubMed

Clin Infect Dis. 2005 Nov 1;41(9):1254-60 PubMed

Zoonoses Public Health. 2011 Feb;58(1):4-20 PubMed

Clin Infect Dis. 2009 Mar 1;48(5):568-76 PubMed

J Med Microbiol. 2007 Jul;56(Pt 7):921-929 PubMed

Epidemiol Infect. 2012 Oct;140(10):1787-93 PubMed

Ann Med Interne (Paris). 2002 Sep;153(5):291-9 PubMed

J Med Microbiol. 2011 Aug;60(Pt 8):1200-1205 PubMed

Curr Opin Infect Dis. 2012 Aug;25(4):405-11 PubMed

Gastroenterology. 2009 May;136(6):1913-24 PubMed

Pathol Biol (Paris). 2008 Nov-Dec;56(7-8):407-11 PubMed

Ribotyping of Clostridioides difficile in the Liberec Regional Hospital: a tertiary health care facility

Antimicrobial resistance in Clostridioides (Clostridium) difficile derived from humans: a systematic review and meta-analysis

Molecular typing and antimicrobial susceptibility testing to six antimicrobials of Clostridium difficile isolates from three Czech hospitals in Eastern Bohemia in 2011-2012

C. difficile ribotype 027 or 176?