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Related Experiment Video

Updated: Oct 23, 2025

Multi-locus Variable-number Tandem-repeat Analysis of the Fish-pathogenic Bacterium Yersinia ruckeri by Multiplex PCR and Capillary Electrophoresis
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Clostridioides difficile Ribotype 027 (RT027) Outbreak Investigation Due to the Emergence of Rifampicin Resistance

Monika Kabała1, Zygmunt Gofron1, Małgorzata Aptekorz1

  • 1Department of Medical Microbiology Medical University of Silesia in Katowice, Katowice, Poland.

Infection and Drug Resistance
|August 25, 2021
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Summary

Multilocus variable tandem repeat analysis (MLVA) identified a Clostridioides difficile (C. diff) outbreak of multidrug-resistant RT 027 strains in a Polish hospital. High resistance to imipenem and rifampicin necessitates further investigation into C. diff control measures.

Keywords:
Clostridioides difficileMLVART 027epidemiologyrifampicin resistance

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Area of Science:

  • Microbiology
  • Infectious Diseases
  • Epidemiology

Background:

  • Clostridioides difficile (C. diff) infections pose a significant threat in healthcare settings.
  • The emergence of multidrug-resistant strains, such as ribotype 027 (RT 027), complicates treatment and control efforts.
  • Outbreaks of C. diff require rapid and accurate molecular investigation to identify transmission pathways.

Purpose of the Study:

  • To investigate a Clostridioides difficile outbreak linked to rifampicin-resistant RT 027 isolates in a Polish tertiary care hospital.
  • To characterize the genetic relatedness of C. diff isolates using Multilocus Variable Tandem Repeat Analysis (MLVA).
  • To determine the antibiotic susceptibility profiles of the implicated C. diff strains.

Main Methods:

  • Twenty-nine C. difficile fecal isolates were collected from patients between November 2017 and February 2018.
  • Isolates were characterized by ribotyping and MLVA for molecular typing.
  • Multiplex PCR was used to detect toxin genes (A, B, binary), and antibiotic susceptibility was determined by E-test.

Main Results:

  • All 29 C. difficile strains harbored genes for toxins A, B, and binary toxins.
  • Strains showed sensitivity to metronidazole and vancomycin but resistance to erythromycin, clindamycin, and moxifloxacin.
  • High resistance rates were observed for imipenem (97%) and rifampicin (45%).
  • MLVA grouped strains into 5 clusters, with cluster II containing 16 strains; strains in other clusters exhibited significantly higher rifampicin resistance.

Conclusions:

  • MLVA confirmed transmission and identified an outbreak of multidrug-resistant RT 027 C. difficile in the hospital.
  • The outbreak is likely linked to environmental spore contamination due to lapses in hygiene and supervision.
  • The high resistance to imipenem and rifampicin among these isolates is concerning and warrants further research.