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Cefoperazone-treated Mouse Model of Clinically-relevant Clostridium difficile Strain R20291
Published on: December 10, 2016
Clostridioides difficile evolution in a tertiary German hospital through a retrospective genomic characterization
Fabian Lorenzo-Diaz1,2, Tilman E Klassert3,4, Cristina Zubiria-Barrera3,4
1Genomics and Health Group, Departamento de Bioquímica, Microbiología, Biología Celular y Genética, Facultad de Ciencias, Canary Islands, Universidad de La Laguna, La Laguna, Spain. florenzo@ull.edu.es.
Clostridioides difficile strains evolved over two decades, with ST1 becoming dominant. Antimicrobial resistance patterns shifted, highlighting the need for integrated genetic surveillance and antibiotic stewardship to manage healthcare-associated infections.
Area of Science:
- Medical Microbiology
- Genomics
- Epidemiology
Background:
- Clostridioides difficile is a significant cause of healthcare-associated infections.
- It leads to substantial patient morbidity and mortality.
- Understanding strain dynamics and resistance is crucial for effective treatment.
Purpose of the Study:
- To investigate genomic characteristics of C. difficile strains.
- To analyze antimicrobial resistance (AMR) profiles and temporal dynamics.
- To track strain evolution in a German hospital from 1997-2015.
Main Methods:
- Whole-genome sequencing of 46 toxigenic C. difficile isolates.
- Phylogenetic analysis and comparison with national surveillance data.
- Antimicrobial susceptibility testing (MIC) and genetic marker identification.
- Analysis of longitudinal antibiotic usage data.
Main Results:
- Five predominant sequence types (STs) identified: ST1 (30%), ST54 (24%), ST3 (22%), ST11 (11%), and ST37 (4%).
- ST1 (ribotype 027) emerged as the dominant, persistent lineage, replacing ST11 and ST54.
- High resistance to moxifloxacin (87%) and rifampicin (59%) observed; susceptibility to fidaxomicin, metronidazole, and vancomycin maintained.
- Genetic markers for carbapenem, MLS, fluoroquinolone, and rifampicin resistance were detected.
Conclusions:
- C. difficile strain evolution in the hospital mirrors national trends.
- Strong correlation between MIC values and molecular resistance markers confirmed.
- Integration of genetic surveillance and antibiotic stewardship is recommended for CDI management.
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