ABSTRACT
BACKGROUND: Clostridium (Clostridioides) difficile infection (CDI) is recognized worldwide as a public health concern, related mainly with hypervirulent strains. In Brazil there are few studies about molecular epidemiology of C. difficile, for this reason, we aimed to characterize C. difficile isolates from a large cohort study of three different Brazilian states to identify virulence and resistance genes, specifically genes related to metronidazole and vancomycin resistance. METHODS: All 153 fecal samples were submitted to C. difficile culture in CM0601 broth. Identification of suspected colonies was confirmed by matrix-assisted laser desorption/ionization (MALDI-TOF/MS, Brucker Daltonics, Germany). The tcdA and tcdB toxin were searched by PCR. The sequence type (ST) was determinate by multilocus sequencing typing (MLST) and susceptibility profile was performed by agar dilution method. RESULTS: Among the 16 isolates, we identified fourteen different STs, five belonging to Clade 1, one to Clade 2 and eight news STs with high similarity levels. Resistance (ermB, tetM, VanW and nimB) and virulence genes (cwp84, cwp66, cwp2, fbpA and secA) were found in toxigenic strains. CONCLUSION: Differently from other studies, we found high levels of resistance to vancomycin. These results suggest that the main circulating strains in Brazil belong to Clade 1 and have high pathogenicity and resistance profile.
Subject(s)
Bacterial Toxins , Clostridioides difficile , Clostridium Infections , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Brazil , Clostridioides difficile/genetics , Clostridium Infections/drug therapy , Clostridium Infections/epidemiology , Cohort Studies , Drug Resistance, Bacterial , Germany , Humans , Multilocus Sequence Typing , Virulence Factors/geneticsSubject(s)
Clostridium Infections/epidemiology , Diarrhea/epidemiology , Diarrhea/microbiology , Adult , Aged , Aged, 80 and over , Brazil/epidemiology , Clostridioides difficile , Female , Humans , Male , Middle Aged , Prevalence , Risk Factors , Young AdultABSTRACT
INTRODUCTION: Clostridium difficile is an important cause of diarrhoea, particularly in patients receiving antibiotic therapy. Recent studies have shown that a substantial proportion of C. difficile infections are acquired in the community, as a zoonotic disease. Brazil is a large exporter of meat and so far no study has evaluated meat contamination with C. difficile spores. METHODS: Here we analysed 80 retail meat products purchased from local supermarkets in a Brazilian metropolis (Porto Alegre, Southern Brazil). Samples from these products were grown in anaerobic conditions, and tested with a real time polymerase chain reaction test. RESULTS: Contamination with C. difficile spores was not found in the study. Bacteria isolated from meat included Streptococcus gallolyticus, Lactobacillus plantarum, Enterococcus gallinarum and Pediococcus acidilactici. DISCUSSION: Close vigilance is required in order to guarantee the quality of Brazilian retail meat in the long term.
Subject(s)
Clostridioides difficile/isolation & purification , Community-Acquired Infections , Food Contamination/analysis , Meat Products/microbiology , Animals , Brazil , Clostridium Infections/epidemiology , Commerce , HumansABSTRACT
ABSTRACT Introduction Clostridium difficile is an important cause of diarrhoea, particularly in patients receiving antibiotic therapy. Recent studies have shown that a substantial proportion of C. difficile infections are acquired in the community, as a zoonotic disease. Brazil is a large exporter of meat and so far no study has evaluated meat contamination with C. difficile spores. Methods Here we analysed 80 retail meat products purchased from local supermarkets in a Brazilian metropolis (Porto Alegre, Southern Brazil). Samples from these products were grown in anaerobic conditions, and tested with a real time polymerase chain reaction test. Results Contamination with C. difficile spores was not found in the study. Bacteria isolated from meat included Streptococcus gallolyticus, Lactobacillus plantarum, Enterococcus gallinarum and Pediococcus acidilactici. Discussion Close vigilance is required in order to guarantee the quality of Brazilian retail meat in the long term.
Subject(s)
Humans , Animals , Food Contamination/analysis , Clostridioides difficile/isolation & purification , Community-Acquired Infections , Meat Products/microbiology , Brazil , Clostridium Infections/epidemiology , CommerceSubject(s)
Clostridioides difficile/genetics , Clostridioides difficile/isolation & purification , Clostridium Infections/diagnosis , Cross Infection/microbiology , Aged , Anti-Bacterial Agents/therapeutic use , Bacterial Proteins/isolation & purification , Bacterial Toxins/isolation & purification , Brazil , Enterotoxins/isolation & purification , Feces/microbiology , Hospitals, University , Humans , Male , Polymerase Chain Reaction , Repressor Proteins/isolation & purificationABSTRACT
The epidemiology of Clostridium difficile infection is virtually unknown in Brazil. In this prospective study, 8.3% of patients with nosocomial diarrhea were found to have toxigenic strains of C difficile in their feces. The relevant risk factors for Clostridium difficile infection were receipt of solid organ transplantation and septic shock.
Subject(s)
Clostridioides difficile/isolation & purification , Clostridium Infections/epidemiology , Cross Infection/epidemiology , Diarrhea/epidemiology , Feces/microbiology , Neglected Diseases/epidemiology , Adult , Aged , Aged, 80 and over , Brazil/epidemiology , Clostridium Infections/chemically induced , Cross Infection/chemically induced , Diarrhea/chemically induced , Female , Humans , Male , Middle Aged , Neglected Diseases/chemically induced , Prevalence , Prospective Studies , Young AdultABSTRACT
Clostridium difficile is the major cause of nosocomial diarrhoea. Several detection methods are available for the laboratory diagnosis of C. difficile, but these vary in terms of sensitivity and specificity. In this study, we compared the performance of three following laboratory tests to detect C. difficile: in-house real-time PCR aiming for toxin B gene (tcdB), EIA for detection of toxins A and B (Premier Toxins A & B) and C. difficile culture in selective medium (bioMerieux). Our results were grouped into three categories as follows: (1) C. difficile-associated diarrhoea (CDAD); (2) asymptomatic carriers; and (3) negative results. Among the 113 patients included in the study, 9 (8.0%) were classified as CDAD, 19 (16.8%) were asymptomatic carriers, 76 (67.2%) had negative results and 9 (8.0%) could not be categorized (positive test for C. difficile toxins only). PCR was found to be the most sensitive diagnostic test in our study, with the potential to be used as a screening method for C. difficile colonization/CDAD. Diagnosis of CDAD would be better performed by a combination of PCR and EIA tests.
