Resistance determinants in strains of Clostridium difficile from two geographically distinct populations.

Ninety-three clinical isolates of Clostridium difficile, comprising 65 from Royal Gwent Hospital, Newport and 28 from Southmead Hospital, Bristol were examined to determine the prevalence of genes coding for macrolide resistance and to explore differences in susceptibility patterns. Antibiogram testing produced similar results for both sets of strains with respect to amoxicillin, tetracycline, erythromycin and cefotaxime. Results differed for rifampicin, where 53% of the Bristol isolates were resistant, compared with 3% of the Newport isolates. Clindamycin disc susceptibility testing produced similar resistance rates. However, clindamycin MIC determinations revealed that 53% of the Bristol strains exhibited high-level resistance (MIC > 256 mg/L), whereas strains from Newport had clindamycin MICs ranging from 0.25 to 3mg/L. erm (B) was present in 15 of the strains from Bristol and in none of the Newport strains. erm (F) and erm (Q) were not detected in either population. The two geographically distinct populations of C. difficile differed considerably in their susceptibility to antibiotics. The possibility that C. difficile may serve as a conservator for resistant determinants subsequent to exposure to antimicrobial agents, has important implications for infection control.

Reproducibility of control organism zone diameters for batches of IsoSensitest agar manufactured from 1996 to 2000 using the BSAC disc susceptibility test method.

The BSAC Working Party on Susceptibility Testing has recently suggested that the performance of IsoSensitest agar has changed since 1991. Twenty batches of IsoSensitest agar that had been manufactured between 1996 and 2000 were tested using the BSAC standardized disc susceptibility testing method. Antibiotic discs containing amoxicillin 10 microg, ceftazidime 30 microg, gentamicin 10 microg, ciprofloxacin 1 microg and colistin sulphate 25 microg were tested on each batch of media 12 times against Escherichia coli ATCC 25922, Staphylococcus aureus ATCC 25923 and Pseudomonas aeruginosa ATCC 27853 where appropriate. There was a small reduction in zone sizes for most antibiotics on batches of media that were near their expiration date, but otherwise zone sizes were remarkably consistent. We could find no evidence to suggest that a change in the performance of IsoSensitest agar for the disc diffusion method had occurred since 1996.