Characterization of clostridium difficile isolated from diarrheal patients in a tertiary-care hospital, Karnataka, South India

Chakraborty Rituparna, Ballal Mamatha, Prabhu M. Mukhyaprana, Hande H. Manjunatha, Pazhani P. Gururaja, Ramamurthy Thandavarayan

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3 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1221-1230
Number of pages10
JournalSoutheast Asian Journal of Tropical Medicine and Public Health
Volume47
Issue number6
Publication statusPublished - 01-01-2016

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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