Characterization of Clostridium Difficile Isolated from Diarrheal Patients in a Tertiary-care Hospital, karnataka, South india

Chakraborty, Rituparna and Ballal, Mamatha and Prabhu, Mukhyaprana M and Hande, Manjunatha H (2016) Characterization of Clostridium Difficile Isolated from Diarrheal Patients in a Tertiary-care Hospital, karnataka, South india. Southeast Asian Journal of Tropical Medicine and Public Health, 47 (6). pp. 1221-1230.

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Abstract

Increase in Clostridium difficile infection in tertiary-care hospitals in Karnataka, South India with a paucity of data on antibiotic susceptibility and genetic characteristics of the pathogen from this region of the country necessitated this study. From April 2012 to December 2014, 480 hospitalized antibiotic-associated diarrhea cases with a history of antibiotic treatment in the previous three weeks were enrolled. Sixteen percent of the samples were positive for C. difficile toxins A and B by rapid enzyme immunoassay, anaerobic culture and multiplex PCR. In 40 representative strains, minimum inhibitory concentrations (MICs) determined by E-test revealed that 39 strains were resistant to imipenem and moxifloxacin (MIC > 32 μg/ml), 38 to clindamycin (MIC > 256 μg/ml) and 19 to tetracycline (MIC > 4 μg/ml), while all 40 strains were susceptible to ampicillin (MIC < 2 μg/ml), ampicillin sulbactam (MIC < 8 μg/ml), metronidazole (MIC < 8 μg/ml) and vancomycin group (MIC < 2 μg/ml). Pulsed field gel-electrophoresis (PFGE) of 13 representative strains grouped them into three clusters: cluster A consisting of two strains having > 65% similarity, cluster B of 6 strains with 100% similarity (considered clonal) and 3 strains with > 85% similarity, and cluster C of 2 strains with 50% similarity. Clusters A and C contained unrelated strains having different antibiograms. Periodic monitoring of resistance profiles with epidemiological typing by PFGE should aid in interpretation of emerging drug resistant C. difficile clones.

Item Type: Article
Uncontrolled Keywords: Clostridium difficile; Antibiogram; Diarrhea; Minimum inhibitory concentration; Pulsed field gel-electrophoresis
Subjects: Medicine > MMMC Manipal > Microbiology
Medicine > KMC Manipal > Medicine
Medicine > KMC Manipal > Microbiology
Depositing User: KMC Library
Date Deposited: 12 Jan 2017 10:56
Last Modified: 12 Jan 2017 10:56
URI: http://eprints.manipal.edu/id/eprint/148018

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