Aptekorz Małgorzata, Sacha Krzysztof, Gofron Zygmunt, Kabała Monika, Harmanus Celine, Kuijper Ed, Martirosian Gayane
Department of Medical Microbiology, School of Medicine in Katowice, Medical University of Silesia, 18 Medyków str., 40-752 Katowice, Poland.
Department of Medical Microbiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.
Pathogens. 2022 Aug 22;11(8):949. doi: 10.3390/pathogens11080949.
Clostridioides difficile is an important health care-associated pathogen. The aim of this study was to analyze the antibiotic susceptibility of C. difficile isolates from feces of patients from 13 hospitals in Silesia, Poland. The incidence of CDI per 100.000 people in Silesia in 2018−2019 was higher than the average in Poland (39.3−38.7 vs. 30.2−29.5, respectively). The incidence doubled from 26.4 in 2020 to 55.1 in 2021. Two hundred and thirty stool samples tested positive for GDH (glutamate dehydrogenase) and toxins were cultured anaerobically for C. difficile. The isolates were characterized, typed, and tested for susceptibility to 11 antibiotics by E-test (EUCAST, 2021). The genes of toxins A/B and binary were detected by mPCR. Of 215 isolates, 166 (77.2%) were classified as RT 027 and 6 (2.8%) as related RT 176. Resistance to ciprofloxacin (96.7%), moxifloxacin (79.1%), imipenem (78.1%), penicillin (67%), and rifampicin (40.5%) was found. The ermB gene was detected in 79 (36.7%) strains. Multidrug resistance (MDR) was confirmed in 50 (23.3%) strains of RT 027 (94%). We concluded that a high prevalence of MDR among hypervirulent RT 027/176 C. difficile was found in the Silesian region of Poland, emphasizing the need to enhance regional infection control on CDI and antibiotic stewardships.
艰难梭菌是一种重要的医疗保健相关病原体。本研究的目的是分析来自波兰西里西亚13家医院患者粪便中艰难梭菌分离株的抗生素敏感性。2018 - 2019年西里西亚每10万人中CDI（艰难梭菌感染）的发病率高于波兰平均水平（分别为39.3 - 38.7对30.2 - 29.5）。发病率从2020年的26.4翻倍至2021年的55.1。对230份GDH（谷氨酸脱氢酶）检测呈阳性且毒素检测呈阳性的粪便样本进行艰难梭菌厌氧培养。对分离株进行特征分析、分型，并通过E-test（欧洲抗菌药物敏感性试验委员会，2021年）检测对11种抗生素的敏感性。通过多重PCR检测毒素A/B和二元毒素的基因。在215株分离株中，166株（77.2%）被分类为RT 027型，6株（2.8%）为相关的RT 176型。发现对环丙沙星（96.7%）、莫西沙星（79.1%）、亚胺培南（78.1%）、青霉素（67%）和利福平（40.5%）耐药。在79株（36.7%）菌株中检测到ermB基因。在50株（23.3%）RT 027型菌株（94%）中证实存在多重耐药（MDR）。我们得出结论，在波兰西里西亚地区发现高毒力RT 027/176型艰难梭菌中多重耐药的患病率很高，强调需要加强该地区对CDI的感染控制和抗生素管理。
