caa a22 4500 606157026 CHVBK 20210128100611.0 cr unu---uuuuu 210128e20150401xx s 000 0 eng 10.1007/s10096-014-2290-9 doi (NATIONALLICENCE)springer-10.1007/s10096-014-2290-9 Molecular epidemiology and antimicrobial susceptibility of Clostridium difficile isolated from a university teaching hospital in Japan [Elektronische Daten] [Y. Kuwata, S. Tanimoto, E. Sawabe, M. Shima, Y. Takahashi, H. Ushizawa, T. Fujie, R. Koike, N. Tojo, T. Kubota, R. Saito] Clostridium difficile infection control strategies require an understanding of its epidemiology. In this study, we analysed the toxin genotypes of 130 non-duplicate clinical isolates of C. difficile from a university hospital in Tokyo, Japan. Multilocus sequence typing (MLST) and eBURST analysis were performed for these isolates and nine strains previously analysed by polymerase chain reaction (PCR) ribotyping. Minimum inhibitory concentrations (MICs) were determined for six antibiotics, and the bacterial resistance mechanisms were investigated. Ninety-five toxigenic strains (73%), including seven tcdA-negative, tcdB-positive and cdtA/cdtB-negative strains (A−B+CDT−) and three A+B+CDT+ strains, and 35 (27%) non-toxigenic strains, were classified into 23 and 12 sequence types, respectively. Of these, sequence type (ST)17 (21.8%) was the most predominant. MLST and eBURST analysis showed that 139 strains belonged to seven groups and singletons, and most A+B+CDT− strains (98%, 89/91) were classified into group 1. All isolates were susceptible to metronidazole, vancomycin and meropenem; the ceftriaxone, clindamycin and ciprofloxacin resistance rates were 49, 59 and 99%, respectively. Resistance rates to ceftriaxone and clindamycin were higher in toxigenic strains than in non-toxigenic strains (P < 0.001). All ST17 and ST81 strains were resistant to these antibiotics. The clindamycin- and fluoroquinolone-resistant strains carried erm(B) and mutations in GyrA and/or GyrB, respectively. To our knowledge, this is the first MLST-based study of the molecular epidemiology of toxigenic and non-toxigenic strains in Japan, providing evidence that non-toxigenic and toxigenic strains exhibit high genetic diversity and that toxigenic strains are more likely than non-toxigenic strains to exhibit multidrug resistance. Springer-Verlag Berlin Heidelberg, 2014 Kuwata Y. Department of Microbiology and Immunology, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113-8510, Tokyo, Japan aut Tanimoto S. Department of Microbiology and Immunology, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113-8510, Tokyo, Japan aut Sawabe E. Infection Control Section, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan aut Shima M. Infection Control Section, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan aut Takahashi Y. Infection Control Section, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan aut Ushizawa H. Infection Control Section, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan aut Fujie T. Infection Control Section, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan aut Koike R. Infection Control Section, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan aut Tojo N. Department of Clinical Laboratory, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan aut Kubota T. Department of Microbiology and Immunology, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113-8510, Tokyo, Japan aut Saito R. Department of Microbiology and Immunology, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113-8510, Tokyo, Japan aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/4(2015-04-01), 763-772 0934-9723 34:4<763 2015 34 10096 https://doi.org/10.1007/s10096-014-2290-9 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-014-2290-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kuwata Y. Department of Microbiology and Immunology, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113-8510, Tokyo, Japan aut NATIONALLICENCE 700 1- Tanimoto S. Department of Microbiology and Immunology, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113-8510, Tokyo, Japan aut NATIONALLICENCE 700 1- Sawabe E. Infection Control Section, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan aut NATIONALLICENCE 700 1- Shima M. Infection Control Section, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan aut NATIONALLICENCE 700 1- Takahashi Y. Infection Control Section, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan aut NATIONALLICENCE 700 1- Ushizawa H. Infection Control Section, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan aut NATIONALLICENCE 700 1- Fujie T. Infection Control Section, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan aut NATIONALLICENCE 700 1- Koike R. Infection Control Section, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan aut NATIONALLICENCE 700 1- Tojo N. Department of Clinical Laboratory, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan aut NATIONALLICENCE 700 1- Kubota T. Department of Microbiology and Immunology, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113-8510, Tokyo, Japan aut NATIONALLICENCE 700 1- Saito R. Department of Microbiology and Immunology, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113-8510, Tokyo, Japan aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/4(2015-04-01), 763-772 0934-9723 34:4<763 2015 34 10096