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A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
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A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment

Published on: May 25, 2017

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The emergence of metronidazole and vancomycin reduced susceptibility in Clostridium difficile isolates in Iran

Ebrahim Kouhsari1, Masoumeh Douraghi2, Marcela Krutova3

  • 1Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran; Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran.

Journal of Global Antimicrobial Resistance
|February 1, 2019
PubMed
Abstract

Insights

Multidrug resistance in Clostridium difficile (C. difficile) is a growing concern. This study found significant antimicrobial resistance in Iranian C. difficile isolates, including reduced susceptibility to key treatments.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Clostridium difficile is a primary cause of antibiotic-associated diarrhea and pseudomembranous colitis.
  • Increasing antimicrobial resistance in C. difficile strains impacts infection epidemiology.
  • Toxigenic C. difficile infections (CDI) pose a significant healthcare challenge.

Purpose of the Study:

  • To investigate antimicrobial resistance patterns of toxigenic C. difficile.
  • To analyze resistance in isolates from hospitalized patients with suspected CDI in Tehran, Iran.

Main Methods:

  • Toxigenic culture of 250 diarrhoeal stool samples.
  • Antimicrobial susceptibility testing using disk diffusion and Etest for metronidazole, vancomycin, clindamycin, tetracycline, and moxifloxacin.
  • Utilized both Clinical and Laboratory Standards Institute and European Committee on Antimicrobial Susceptibility Testing breakpoints.

Main Results:

  • 14% (35/250) of samples were positive for toxigenic C. difficile.
  • High resistance rates observed for clindamycin (18/35) and moxifloxacin (7/35).
  • Reduced susceptibility noted for metronidazole (14/35) and vancomycin (3/35) based on EUCAST breakpoints.

Conclusions:

  • Multidrug resistance is present in Iranian clinical toxigenic C. difficile isolates.
  • Reduced susceptibility to first-line CDI treatments was identified.
  • Disk diffusion is a cost-effective method for C. difficile antimicrobial susceptibility testing.
Keywords:
Antimicrobial susceptibility testingClostridium difficileDisc diffusionIranResistance

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