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Published on: December 10, 2016
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Clostridioides difficile from Fecally Contaminated Environmental Sources: Resistance and Genetic Relatedness from a
Khald Blau1, Fabian K Berger2,3, Alexander Mellmann3,4
1Department of Microbiology-Biotechnology, Faculty of Technology, University of Applied Sciences Emden/Leer, 26723 Emden, Germany.
Microorganisms
|October 28, 2023
Summary
Clostridioides difficile environmental isolates show diverse virulence factors and antimicrobial resistance (AMR). Some strains linked to community-associated C. difficile infection (CA-CDI) suggest potential zoonotic transmission from environmental sources.
Area of Science:
- Environmental microbiology
- Infectious diseases
- Genomics
Background:
- Clostridioides difficile is a major cause of antimicrobial-associated diarrhea.
- Community-associated C. difficile infection (CA-CDI) is an emerging concern.
- Environmental reservoirs of C. difficile are not fully understood.
Purpose of the Study:
- To characterize virulence factors, antimicrobial resistance (AMR), and ribotype (RT) distribution of C. difficile from environmental sources.
- To investigate the genetic relationships of environmental C. difficile isolates.
- To assess the potential link between environmental C. difficile and CA-CDI.
Main Methods:
- Isolation of C. difficile from environmental samples in Northern Germany.
- Antimicrobial susceptibility testing (E-test, disk diffusion).
- PCR for toxin genes (tcdA, tcdB, cdtAB) and ribotyping.
- Whole genome sequencing (WGS) for core genome multi-locus sequence typing (cgMLST), AMR, and virulence genes.
Main Results:
- 89% of isolates were toxigenic; 51% carried binary toxin genes (cdtAB).
- Thirty distinct ribotypes (RTs) and 32 sequence types (STs) were identified, with RT127, RT126, RT001, RT078, and RT014 being most common.
- All isolates were susceptible to vancomycin and metronidazole; variable resistance to moxifloxacin (14%), clarithromycin (26%), and rifampicin (2%) was observed.
- AMR genes conferring resistance to fluoroquinolones, beta-lactams, aminoglycosides, macrolides, and tetracyclines were identified.
- Several RTs associated with CA-CDI were detected, suggesting potential human-environment transmission and zoonotic potential.
Conclusions:
- Environmental C. difficile isolates exhibit significant genetic diversity and carry virulence and AMR genes.
- The presence of CA-CDI-associated RTs in the environment highlights potential zoonotic transmission routes.
- Further research is needed to understand the role of environmental sources in C. difficile epidemiology.
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