The emergence of metronidazole and vancomycin reduced susceptibility in Clostridium difficile isolates in Iran
Jazyk angličtina Země Nizozemsko Médium print-electronic
Typ dokumentu časopisecké články, multicentrická studie, práce podpořená grantem
PubMed
30703583
DOI
10.1016/j.jgar.2019.01.027
PII: S2213-7165(19)30034-7
Knihovny.cz E-zdroje
- Klíčová slova
- Antimicrobial susceptibility testing, Clostridium difficile, Disc diffusion, Iran, Resistance,
- MeSH
- centra terciární péče MeSH
- Cercopithecus aethiops MeSH
- Clostridioides difficile účinky léků růst a vývoj MeSH
- feces mikrobiologie MeSH
- klostridiové infekce farmakoterapie mikrobiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- metronidazol farmakologie terapeutické užití MeSH
- mikrobiální testy citlivosti MeSH
- mnohočetná bakteriální léková rezistence * MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- vankomycin farmakologie terapeutické užití MeSH
- Vero buňky MeSH
- zvířata MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Írán MeSH
- Názvy látek
- metronidazol MeSH
- vankomycin MeSH
OBJECTIVES: Clostridium difficile (C. difficile) is the main causative agent of antibiotic-associated diarrhoea (AAD) and pseudomembranous colitis. The accumulation of antimicrobial resistance in C. difficile strains can drive C. difficile infection (CDI) epidemiology. This study was undertaken to evaluate the antimicrobial resistance patterns of toxigenic C. difficile isolates cultured from diarrhoeal stool samples of hospitalised patients with suspected CDI in three tertiary care hospitals in Tehran, Iran. METHODS: Two hundred and fifty diarrhoeal stool samples were investigated by toxigenic culture using cycloserine-cefoxitin-fructose agar and the VERO cell line. Antimicrobial susceptibility to metronidazole, vancomycin, clindamycin, tetracycline, and moxifloxacin was performed by disk diffusion and Etest methods on Brucella Blood Agar supplemented with hemin and vitamin K. RESULTS: Thirty-five stool samples (14.0%) proved positive using C. difficile toxigenic culture. According to Clinical and Laboratory Standards Institute breakpoints, the following resistance was identified in C. difficile isolates: metronidazole (2 of 35); moxifloxacin (7 of 35); clindamycin (18 of 35); and tetracycline (5 of 35). Using European Committee on Antimicrobial Susceptibility Testing breakpoints, three of 35 isolates showed reduced-susceptibility for vancomycin and 14 of 35 for metronidazole. In addition, the results showed a good correlation between the inhibition zone diameter (disk diffusion) and MIC values (Etest); Pearson correlation coefficient 0.7400.95 (P< 0.001). CONCLUSIONS: Multidrug resistance was observed in Iranian clinical toxigenic C. difficile isolates, including reduced susceptibility to first-line CDI treatment drugs. In addition, disk diffusion can be used as a cost-effective option for the antimicrobial susceptibility testing of C. difficile isolates.
Department of Biostatistics School of Health Mazandaran University of Medical Sciences Sari Iran
Department of Microbiology School of Medicine Iran University of Medical Sciences Tehran Iran
Citace poskytuje Crossref.org
