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        Circulation of Highly Drug-Resistant Clostridium difficile Ribotypes 027 and 001 in Two Tertiary-Care Hospitals in Mexico

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        AMR_Manuscript_v2_190118.docx.pdf (PDF, 389Kb)
        Author
        Adrian Martinez-Melendez, Adrian
        Tijerina-Rodrıguez, Laura
        Morfin-Otero, Rayo
        Camacho-Ortiz, Adrian
        Villarreal-Trevino, Licet
        Sanchez-Alanıs, Hugo
        Rodrıguez-Noriega, Eduardo
        Baines, Simon
        Flores-Trevino, Samantha
        Maldonado-Garza, Hector Jesus
        Garza-Gonzalez, Elvira
        Attention
        2299/22495
        Abstract
        OBJECTIVE: To assess drug susceptibility and characterize Clostridium difficile ribotypes in isolates from two tertiary-care hospitals in Mexico. METHODS: Isolates were evaluated for genotyping, antimicrobial susceptibility testing and detection of mutations associated with drug resistance. PCR ribotyping was performed using a combination of gel-based and capillary electrophoresis-based approaches. RESULTS: MIC50 and MIC90 were ≥128 mg/L for ciprofloxacin, erythromycin, clindamycin, and rifampicin. There was no reduced susceptibility to metronidazole or tetracycline; however, reduced susceptibility to vancomycin (≥4 mg/L) and fidaxomicin (≥2 mg/L) was detected in 50 (40.3%) and 4 (3.2%) isolates, respectively. Furthermore, the rpoB Arg505Lys mutation was more frequently detected in isolates with high minimum inhibitory concentration (MIC) to rifampicin (≥32 mg/L) (OR = 52.5; 95% CI = 5.17-532.6; p < 0.000). Of the 124 C. difficile isolates recovered, 84 (66.7%) were of ribotype 027, 18 (14.5%) of ribotype 001, and the remainder were other ribotypes (353, 255, 220, 208, 176, 106, 076, 020, 019, 017, 014, 012, 003, and 002). CONCLUSION: Ribotypes 027 and 001 were the most frequent C. difficile isolates recovered in this study, and demonstrated higher MICs. Furthermore, we found four isolates with reduced susceptibility to fidaxomicin, raising a concern since this drug is currently unavailable in Mexican Hospitals.
        Publication date
        2018-05-01
        Published in
        Microbial Drug Resistance
        Published version
        https://doi.org/10.1089/mdr.2017.0323
        Other links
        http://hdl.handle.net/2299/22495
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