ABSTRACT
Clostridioides (Clostridium) difficile infection (CDI) is an evolving global healthcare problem, and owing to the diverse and dynamic molecular epidemiology of C. difficile, new strains continue to emerge. In Brazil, only two cases of CDI due to the so called hypervirulent PCR ribotype (RT) 027 belonging to clade 2 have ever been reported, whereas incidence of CDI due to another "hypervirulent" RT078 (clade 5) has not yet been reported. In contrast, novel clade 2 strains have been identified in different hospitals. To better understand the epidemiology of CDIs in Brazil, this study aimed to genotypically and phenotypically characterize three novel Brazilian clade 2 strains (RT883, 884, and 885) isolated from patients with confirmed CDI. In addition, to better understand the circulating RTs, a two-year sampling was conducted in patients from the same hospital and in several domestic and wild animal species. The three strains examined showed lower production of A/B toxins than the control RT027, although two of these strains harbored a truncated tcdC gene. All strains showed swimming motility similar to that of RT027, while RT883 showed higher spore production than the reference strain. In the in vivo hamster model, the lethality of all strains was found to be similar to that of RT027. Both cgMLST and cgMLSA analyses revealed a high genetic similarity among the three-novel clade 2 isolates. In the two-year survey in animals and humans, RT883, 884, and 885 were not detected; however, three new RTs (RT988, RT989, and RT990) were isolated, two of which were genetically related to the three previously reported clade 2 strains. RT106 and RT126 were most frequently detected in humans (47.9%) and animals (57.9%), respectively. Furthermore, RT027 and RT078 were not detected in humans. The results of this study suggest that these novel clade 2 strains have virulence potential and that new strains from clade 2 continue to emerge in our setting, indicating the need for long-term local surveillance.
Subject(s)
Clostridioides difficile , Clostridium Infections , Enterocolitis, Pseudomembranous , Animals , Brazil , Clostridioides , Clostridium , Humans , Ribotyping , VirulenceABSTRACT
ABSTRACT: Clostridioides (Clostridium) difficile is the main causative agent of antimicrobial-related diarrhea in humans and a major pathogen-associated enteric disorder in foals and adult horses. Moreover, studies have suggested that animals are a possible reservoir of toxigenic C. difficile strains for humans. Despite this known importance, the epidemiology of C. difficile infection (CDI) in equine is still largely unknown. Therefore, this study described six cases of equine CDI occurring in Minas Gerais, Brazil, including the characterization of the isolates. All but one equine included in this research developed CDI after antimicrobial therapy, three of which occurred during hospitalization. Coinfection with Salmonella Heidelberg and S. Infantis was detected in three cases, making the antimicrobial treatment challenging. All animals recovered after metronidazole administration. All C. difficile isolates were susceptible to metronidazole and vancomycin, while three were resistant to moxifloxacin and two were resistant to clindamycin. The isolates were classified as RT126 (n = 4), RT078 (n = 1), and RT014/020 (n = 1), all previously reported infecting humans and animals worldwide.
RESUMO: Clostridioides (Clostridium) difficile é o principal agente envolvido em diarreias associadas ao uso de antimicrobianos em seres humanos e um enteropatógeno de grande relevância em quadros de diarreia em potros e equinos adultos. Em adição, estudos tem sugerido que animais são possíveis reservatórios de estirpes toxigênicas de C. difficile para humanos. Apesar da importância na saúde animal e humana, a epidemiologia da infecção por C. difficile (ICD) é ainda pouco conhecida. Dessa forma, o presente estudo tem como objetivo caracterizar seis casos de diarreia por C. difficile ocorridos em Minas Gerais, Brasil. Com exceção de um animal, todos os equinos incluídos no presente estudo desenvolveram ICD após antibioticoterapia, três dos quais durante a hospitalização. Coinfecção por Salmonella Heidelberg e S. Infantis foi detectada em três casos, tornando o tratamento antimicrobiano desafiador. Todos os animais recuperaram após administração de metronidazol. Os isolados obtidos no presente estudo foram sensíveis a metronidazol e vancomicina, porém três estirpes foram resistentes a moxifloxacina e duas a clindamicina. Os isolados foram classificados como ribotipos 126 (n=4), 078 (n=1) e 014/020 (n=1), todos previamente relatados em seres humanos com ICD no Brasil e em outros países.
ABSTRACT
The oral administration of non-toxigenic strains of Clostridioides difficile (NTCD) is currently showing promising results for the prevention of Clostridioides difficile infection (CDI) in humans and animals, and is being considered as a possible commercial product to be used in the near future. The aim of this work was to evaluate five culture media for the growth and sporulation of one NTCD (Z31) and evaluate the viability of a lyophilized spore solution of NTCD Z31 stored at 4 °C or at 25 °C for 2 years. Reinforced clostridial medium (RCM) and brain heart infusion broth (BHI) provided the highest production of NTCD Z31 spores. In the first 6 months of the storage of the lyophilized solution, a reduction in spore count of approximately 0.3 Log10 CFU/mL was observed; however, no further significant reduction in spore count was observed up to 24 months. No difference in spore concentration was found between the two storage temperatures from 6 to 24 months of storage. The present work showed BHI and RCM to be the best choices for the growth and sporulation of NTCD Z31 and suggested that the spores of NTCD Z31 are stable for up to 2 years under both temperature conditions.
Subject(s)
Clostridioides difficile/growth & development , Preservation, Biological/methods , Animals , Clostridioides difficile/metabolism , Culture Media/metabolism , Microbial Viability , Preservation, Biological/instrumentation , Spores, Bacterial/growth & development , Spores, Bacterial/metabolismABSTRACT
One of the main challenges associated with Clostridioides difficile infection (CDI) in humans and domestic animals is the lack of an effective preventive strategy. One strategy with promising results is the oral administration of non-toxigenic strains of C. difficile (NTCD). Recently, Z31, a NTCD strain isolated from a healthy dog, showed promising results to prevent CDI in hamsters. Thus, the present study aimed to evaluate the capacity of Z31 to prevent CDI in piglets using an experimental model. Twenty neonatal piglets were randomly distributed in three groups: G1 - 106 spores of Z31 followed by 107 spores of a toxigenic C. difficile strain (nâ¯=â¯7), G2 (positive control) - 107 spores of a toxigenic C. difficile strain (nâ¯=â¯7), and G3 (negative control) - no biological inoculum (nâ¯=â¯6). All animals were kept in individual insulators and observed for 60â¯h. Data regarding clinical signs, macro and microscopic lesions, toxigenic culture of C. difficile, and detection of A/B toxins in the feces were evaluated. All evaluated parameters were significantly lower in animals that received Z31 compared to the positive control. Thus, oral administration of Z31 was able to prevent CDI in piglets in an experimental model.
Subject(s)
Antibiosis , Biological Therapy/methods , Clostridiales/growth & development , Clostridium Infections/prevention & control , Administration, Oral , Animals , Animals, Newborn , Bacterial Toxins/analysis , Clostridium Infections/microbiology , Clostridium Infections/pathology , Disease Models, Animal , Feces/chemistry , Swine , Treatment OutcomeABSTRACT
ABSTRACT: Despite the known importance of Clostridium perfringens as an enteropathogen in small ruminants, little is known about the role of its additional virulence factors or the frequency of the various C. perfringens genotypes in healthy goats; this complicates the laboratory diagnosis of the infections caused by this microorganism. In light of this, the aim of the present study was to isolate and genotype C. perfringens from stool samples from healthy goats in Brazil. Stool samples from 250 apparently healthy adult goats from 17 different herds in Minas Gerais, Brazil were collected, and isolation and genotyping of C. perfringens was performed. C. perfringens type A was isolated from 189 (75.6%) goats, whereas C. perfringens types C and D were each detected in one goat (0.4%). All isolates were negative for enterotoxin-, NetB-, NetE-, and NetF-encoding genes. These results confirmed C. perfringens type A as part of the microbiota in these animals, and they suggested that C. perfringens type C and D are rarely isolated from healthy goats.
RESUMO: Apesar da reconhecida importância de Clostridium perfringens como enteropatógeno de pequenos ruminantes, pouco se sabe sobre a frequência dos genótipos ou do papel de fatores de virulência adicionais de C. perfringens em cabras saudáveis, dificultando o diagnóstico laboratorial da infecção causada por esse micro-organismo. Dessa forma, o presente estudo teve como objetivo caracterizar C. perfringens de amostras de fezes de cabras adultas saudáveis. Amostras de fezes de 250 cabras saudáveis de 17 rebanhos diferentes em Minas Gerais, Brasil, foram submetidas ao isolamento e genotipagem de C. perfringens. C. perfringens tipo A foi isolado de 189 (75,6%) cabras, enquanto C. perfringens tipos C e D foram detectados em um animal (0.4%) cada. Todos os isolados foram negativos para os genes codificadores das toxinas NetB, NetE, NetF e enterotoxina. Os resultados apresentados confirmam C. perfringens tipo A como parte da microbiota de cabras saudáveis e sugere que C. perfringens tipos C e D são raramente encontrados em caprinos saudáveis.
