Hospital outbreak due to Clostridium difficile ribotype 018 (RT018) in Southern Germany.
Anti-Bacterial Agents
Bacterial Toxins
/ genetics
Clostridioides difficile
/ classification
Clostridium Infections
/ epidemiology
Cross Infection
/ epidemiology
DNA, Bacterial
/ genetics
Diarrhea
/ epidemiology
Disease Outbreaks
Drug Resistance, Bacterial
Genome, Bacterial
/ genetics
Germany
/ epidemiology
Humans
Microbial Sensitivity Tests
Minisatellite Repeats
/ genetics
Multilocus Sequence Typing
Phylogeny
Polymerase Chain Reaction
Ribotyping
Antibiotic susceptibility
Epidemiology
Resistance testing
Transmission
Journal
International journal of medical microbiology : IJMM
ISSN: 1618-0607
Titre abrégé: Int J Med Microbiol
Pays: Germany
ID NLM: 100898849
Informations de publication
Date de publication:
Historique:
received:
11
12
2018
revised:
18
02
2019
accepted:
04
03
2019
pubmed:
19
3
2019
medline:
5
9
2019
entrez:
19
3
2019
Statut:
ppublish
Résumé
Clostridium (Clostridioides) difficile is the main cause of nosocomial diarrhoea. Ribotype 018 (RT018) has been recognized as the predominant strain responsible for C. difficile infection (CDI) in Italy, whereas in most other European countries only sporadic RT018 cases occur. Between August and October 2015, a suspected C. difficile outbreak at two associated hospitals in Southern Germany was investigated by comprehensive molecular typing. Surprisingly, RT018 was detected in 9/82 CDI patients, which has never been described before in a German outbreak. Phenotypic analysis revealed fluoroquinolone and macrolide resistance. Genetic subtyping using multiple-locus variable-number tandem-repeat analysis (MLVA) and whole genome sequencing (WGS) was performed and outbreak isolates were directly compared to sporadic German RT018 isolates and to epidemic ones from Milan, Northern Italy. Molecular typing confirmed a hospital outbreak with closely related RT018 isolates. Both, MLVA and WGS revealed high similarity of outbreak strains with epidemic isolates from Italy, but low similarity to other German isolates. Comparison between both typing strategies showed that ribotyping in combination with MLVA was appropriate to identify related isolates and clonal complexes, whereas WGS provided a better discrimination with more detailed information about the phylogenetic relationship of isolates. This is the first hospital outbreak in Germany presumably caused by cross-national transmission of an Italian epidemic RT018 strain.
Identifiants
pubmed: 30879971
pii: S1438-4221(18)30613-1
doi: 10.1016/j.ijmm.2019.03.001
pii:
doi:
Substances chimiques
Anti-Bacterial Agents
0
Bacterial Toxins
0
DNA, Bacterial
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
189-193Informations de copyright
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