Résumé
The in vitro inhibitory action of teicoplanin, vancomycin, metronidazole and clindamycin against clinical isolates of Clostridium difficile was investigated. Minimum inhibitory concentrations (MICs) were determined using E test. Teicoplanin (MIC range 0.023-0.75 microgram/ml), vancomycin (MIC range 0.5-3 micrograms/ml) and metronidazole (MIC range 0.19-1 microgram/ml) were all very active against the isolates examined. No resistant strains of C. difficile to those three antimicrobial agents were observed, whereas resistance to clindamycin was found in 39.5% of the tested strains. Teicoplanin was about 4-times more potent than vancomycin. It appears to be a more promising antimicrobial for treatment of C. difficile enteric disease.
Sujets)
Antibactériens/pharmacologie , Antitrichomonas/pharmacologie , Clindamycine/pharmacologie , Clostridioides difficile/effets des médicaments et des substances chimiques , Relation dose-effet des médicaments , Métronidazole/pharmacologie , Tests de sensibilité microbienne , Téicoplanine/pharmacologie , Vancomycine/pharmacologieRésumé
The reactivity of a commercial latex test with thirty-three species of bacteria was tested. Toxigenic and nontoxigenic strains of Clostridium difficile gave a positive result in the CD D-1 latex test. Cross-reactions were also given by C. putrificum, C. sporogenes and proteolytic C. botulinum.
Sujets)
Bactéries/immunologie , Clostridioides difficile/immunologie , Réactions croisées , Diarrhée/microbiologie , Études d'évaluation comme sujet , Humains , Tests au latex/instrumentationRésumé
Over a twenty-six month period 383 fecal specimens from 269 diarrheal patients and 114 control patients were examined for Clostridium difficile and its cytotoxin. C. difficile was isolated from 13 (4.8%) of overall age group of diarrheal patients and from 3 (2.6%) of controls. Fecal cytotoxin was detected in 106 (52.5%) of 203 diarrheal patients and in 17 (22.4%) of 76 controls. Sixty-one percent of antibiotic-associated diarrheal patients (less than 3 years) and 51% of non-antibiotic associated diarrhea patients had fecal cytotoxin. Enteric pathogens other than C. difficile were detected in 0.7-7.4% of the patients studied. These data suggest that C. difficile associated disease may be frequently encountered in such a developing region studied. Routine diagnosis for C. difficile in diarrheal patients appears to be warranted.