Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
Anaerobe. 2013 Aug;22:45-9. doi: 10.1016/j.anaerobe.2013.05.009. Epub 2013 Jun 10.
Clostridium difficile is an emerging pathogen for humans and animals and there is concern about the possibility that livestock might serve as a reservoir of epidemic strains. In Spain, ribotype 078 is one of the most prevalent in human episodes of C. difficile infection, but the distribution of this and other ribotypes in animals is yet unknown. We present the first report on the ribotype distribution and antimicrobial susceptibility of C. difficile in swine in Spain. A total of 144 isolates were PCR ribotyped, and their MIC values for 13 antimicrobial agents were determined using the Etest. Toxins A and B production was assessed using a commercial immunoassay and, in the case of toxin B, a specific cytotoxicity test. Our results show a high prevalence of the toxigenic 078 ribotype (94.4%) and multidrug resistance (49.3%) among the studied isolates. A minority of isolates (5.6%) belonged to a mostly non-toxinogenic ribotype. All isolates were resistant to the fluoroquinolone ciprofloxacin, but susceptible to daptomycin, linezolid, meropenem, rifampicin, teicoplanin, tigecycline, metronidazole and vancomycin. Resistance to clindamycin, ertapenem, erythromycin and moxifloxacin was common (≥27.8% in all cases). Resistance rates for the different antibiotics tested were in all cases independent from the ribotype of isolates and the host's condition (diarrheic or non-diarrheic), but erythromycin and moxifloxacin resistance was associated with the geographic origin of isolates. Metronidazole heteroresistance was found among animal isolates of C. difficile. Our results highlight the role of livestock as a potential source of epidemic multidrug resistant strains in Spain.
艰难梭菌是一种新兴的人类和动物病原体，人们担心家畜可能成为流行菌株的储存库。在西班牙，078 型是人类艰难梭菌感染病例中最常见的之一，但这种和其他型别的艰难梭菌在动物中的分布尚不清楚。我们首次报道了西班牙猪群中艰难梭菌的核糖体型分布和抗菌药物敏感性。对 144 株分离株进行了 PCR 核糖体型分析，并使用 Etest 测定了它们对 13 种抗菌药物的 MIC 值。使用商业免疫测定法评估了毒素 A 和 B 的产生，并且在毒素 B 的情况下，使用了特定的细胞毒性试验。我们的结果显示，在研究的分离株中，毒力 078 核糖体型（94.4%）和多药耐药性（49.3%）的流行率很高。少数分离株（5.6%）属于主要非产毒核糖体型。所有分离株均对氟喹诺酮环丙沙星耐药，但对达托霉素、利奈唑胺、美罗培南、利福平、替考拉宁、替加环素、甲硝唑和万古霉素敏感。克林霉素、厄他培南、红霉素和莫西沙星的耐药性很常见（所有情况下均≥27.8%）。对不同抗生素的耐药率在所有情况下均与分离株的核糖体型和宿主的状况（腹泻或非腹泻）无关，但红霉素和莫西沙星的耐药性与分离株的地理来源有关。在艰难梭菌的动物分离株中发现了甲硝唑异质性耐药。我们的结果强调了家畜作为西班牙流行的多药耐药菌株的潜在来源的作用。
