Journal
DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE
Volume 91, Issue 2, Pages 105-111Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.diagmicrobio.2018.01.017
Keywords
Clostridium difficile; Antimicrobial susceptibility testing; Ribotype 027; Canada
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Funding
- Health Sciences Centre, University of Manitoba
- National Microbiology Laboratory-Public Health Agency of Canada
- Merck & Co., Inc. (Kenilworth, NJ)
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Clostridium difficile toxin-positive diarrhea] stool specimens submitted to eight Canadian hospital laboratories from 2013 to 2015 were cultured. Polymerase chain reaction ribotyping of isolates was performed using an internationally standardized, high-resolution capillary gel-based electrophoresis protocol and antimicrobial susceptibility testing conducted by CLSI-defined agar dilution (M11-A8, 2012). Among the 1310 isolates of C. difficile cultured, 141 different ribotypes were identified; the most common ribotypes were 027 (24.5% of isolates), 014 (7.7%), 020 (6.6%), 106 (6.1%), and 002 (4.6%). Ribotype 027 was the commonest ribotype in all geographic regions of Canada and was more frequently isolated from patients aged years (40.6%) than younger patients (P<0.00001). Ribotype 027 isolates were frequently moxifloxacin-resistant (92.2% of isolates) and multidrug-resistant (49.5%). Fidaxomicin demonstrated the greatest in vitro potency (lowest MIC90. 0.5 mu g/mL; lowest maximum MIC, 2 mu g/mL) of eight antimicrobial agents tested and was the most active agent against each of the five commonest ribotypes (MIC90, 0.25-1 mu g/mL). (C) 2018 Elsevier Inc. All rights reserved.
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