Universität zu Köln

Piepenbrock, E., Stelzer, Y., Berger, F. and Jazmati, N. (2019). Changes in Clostridium (Clostridioides) difficile PCR-Ribotype Distribution and Antimicrobial Resistance in a German Tertiary Care Hospital Over the Last 10Years. Curr. Microbiol., 76 (4). S. 520 - 527. NEW YORK: SPRINGER. ISSN 1432-0991

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Abstract

Clostridium (Clostridioides) difficile ribotype 027 (RT027) was detected in Germany for the first time in 2007 during an outbreak in the region of Trier, Rhineland-Palatinate and is today the most prevalent ribotype (RT) in Europe. We aimed to determine the changes in RT distribution and corresponding antimicrobial resistance in clinical C. difficile isolates between two time points (2007 and 2017) in one tertiary care hospital in Germany. C. difficile isolates recovered in 2007 and in 2017 (80 isolates per year, respectively) from patients at a Tertiary Care University Hospital in North-Rhine Westphalia were analyzed. Isolates were characterized by ribotyping and susceptibility testing using gradient tests (metronidazole, vancomycin) and the disk diffusion method (moxifloxacin). Between 2007 and 2017, a clear switch from RT001 [18.75% (n=15) in 2007 versus 3.75% (n=3) in 2017 P=0.003] to RT027 [0% in 2007 versus 21.25% (n=17) in 2017] was evident. While minimal inhibitory concentrations (MICs) of vancomycin were stable, a significant metronidazole MIC creep was determined (MIC50=0.047 in 2007 versus MIC50=0.094 in 2017, P<0.0001 using the Man-Whitney test). We detected one metronidazole-resistant isolate (0.6%). Interestingly, in total we encountered more isolates resistant to moxifloxacin in 2007 (42 (52.25%) than in 2017 [(30 (37.5%), P=0.06)]). We could demonstrate that RT027 replaced RT001 in the last 10years in our hospital. Furthermore, our data show a metronidazole MIC creep in C. difficile isolates over the last 10years and an unexpected decrease of isolates resistant to moxifloxacin.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Piepenbrock, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stelzer, Y. UNSPECIFIED UNSPECIFIED UNSPECIFIED Berger, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jazmati, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-152796
DOI:	10.1007/s00284-019-01654-3
Journal or Publication Title:	Curr. Microbiol.
Volume:	76
Number:	4
Page Range:	S. 520 - 527
Date:	2019
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-0991
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language REDUCED SUSCEPTIBILITY; EMERGENCE; INFECTION; METRONIDAZOLE; EPIDEMIOLOGY; SURVEILLANCE; MOXIFLOXACIN; EUROPE Multiple languages Microbiology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/15279