Department of Medical Microbiology, Medical University of Warsaw, Poland; Department of Medical Microbiology, The Infant Jesus Teaching Hospital, Warsaw, Poland.
Department of Medical Microbiology, Medical University of Warsaw, Poland.
Anaerobe. 2020 Apr;62:102167. doi: 10.1016/j.anaerobe.2020.102167. Epub 2020 Feb 13.
Two hundred and fifty-three non-duplicate toxigenic Clostridium difficile isolates, collected from February 2012 to December 2014, were evaluated for phenotypic resistance to ten antimicrobial drugs with the E-test gradient diffusion method. All strains of C. difficile were susceptible to metronidazole, vancomycin, and tigecycline. The metronidazole MIC values of the hyperepidemic PCR-ribotypes RT027 and RT176 were higher than those of non-epidemic PCR-ribotypes (p < 0.05, as evidenced by Mann-Whitney U test). In contrast, vancomycin susceptibility did not differ between hyperepidemic and non-epidemic strains, although the difference was almost significant (p = 0.065). Clostridium difficile RT027 and RT176 isolates could be assessed to five and four different susceptibility patterns, respectively, representing various combinations of resistance to different antimicrobial classes. A single point mutation (Thr82Ile) in the gyrA gene was detected in 11 (78.6%) of 14 isolates with high level of resistance to ciprofloxacin and moxifloxacin and four different types of single point mutations (Arg447Lys, Ser416Ala, Asp426Val, Asp426Asn) in the gyrB gene were detected in 4 strains, also with high level of resistance to ciprofloxacin and moxifloxacin. Four different point mutations were detected in the rpoB gene in 21 rifampicin-resistant strains of which one has not been reported previously, Gln489Leu. This study demonstrates the presence of multidrug-resistant C. difficile strains in Polish hospitals over the study period, irrespective of geographical location or reference level of the hospital.
从 2012 年 2 月至 2014 年 12 月，共收集了 253 株非重复产毒艰难梭菌分离株，采用 E 试验梯度扩散法评估其对 10 种抗菌药物的表型耐药性。所有艰难梭菌对甲硝唑、万古霉素和替加环素均敏感。高流行型 PCR-ribotype RT027 和 RT176 的甲硝唑 MIC 值高于非流行型 PCR-ribotype（Mann-Whitney U 检验，p < 0.05）。相比之下，高流行型和非流行型菌株对万古霉素的敏感性无差异，尽管差异接近显著（p = 0.065）。艰难梭菌 RT027 和 RT176 分离株可分别评估 5 种和 4 种不同的药敏模式，分别代表不同抗菌药物类别的耐药性的各种组合。在对环丙沙星和莫西沙星高度耐药的 14 株分离株中检测到 11 株（78.6%）gyrA 基因的单个点突变（Thr82Ile），在 4 株对环丙沙星和莫西沙星也高度耐药的分离株中检测到 4 种不同类型的单个点突变（Arg447Lys、Ser416Ala、Asp426Val、Asp426Asn）gyrB 基因。在 21 株利福平耐药的 rpoB 基因中检测到 4 种不同的点突变，其中一种以前没有报道过，Gln489Leu。本研究表明，在研究期间，波兰医院存在多药耐药艰难梭菌菌株，无论地理位置或医院参考水平如何。
