Repository of Research and Investigative Information

Repository of Research and Investigative Information

Ilam University of Medical Sciences

The emergence of metronidazole and vancomycin reduced susceptibility in Clostridium difficile isolates in Iran

Wed Jun 19 00:04:00 2024

(2019) The emergence of metronidazole and vancomycin reduced susceptibility in Clostridium difficile isolates in Iran. Journal of Global Antimicrobial Resistance. pp. 28-33. ISSN 2213-7173 (Electronic) 2213-7165 (Linking)

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OBJECTIVES: Clostridium difficile (C. difficile) is the main causative agent of antibiotic-associated diarrhoea (AAD) and pseudomembranous colitis. The accumulation of antimicrobial resistance in C. difficile strains can drive C. difficile infection (CDI) epidemiology. This study was undertaken to evaluate the antimicrobial resistance patterns of toxigenic C. difficile isolates cultured from diarrhoeal stool samples of hospitalised patients with suspected CDI in three tertiary care hospitals in Tehran, Iran. METHODS: Two hundred and fifty diarrhoeal stool samples were investigated by toxigenic culture using cycloserine-cefoxitin-fructose agar and the VERO cell line. Antimicrobial susceptibility to metronidazole, vancomycin, clindamycin, tetracycline, and moxifloxacin was performed by disk diffusion and Etest methods on Brucella Blood Agar supplemented with hemin and vitamin K. RESULTS: Thirty-five stool samples (14.0) proved positive using C. difficile toxigenic culture. According to Clinical and Laboratory Standards Institute breakpoints, the following resistance was identified in C. difficile isolates: metronidazole (2 of 35); moxifloxacin (7 of 35); clindamycin (18 of 35); and tetracycline (5 of 35). Using European Committee on Antimicrobial Susceptibility Testing breakpoints, three of 35 isolates showed reduced-susceptibility for vancomycin and 14 of 35 for metronidazole. In addition, the results showed a good correlation between the inhibition zone diameter (disk diffusion) and MIC values (Etest); Pearson correlation coefficient 0.7400.95 (P< 0.001). CONCLUSIONS: Multidrug resistance was observed in Iranian clinical toxigenic C. difficile isolates, including reduced susceptibility to first-line CDI treatment drugs. In addition, disk diffusion can be used as a cost-effective option for the antimicrobial susceptibility testing of C. difficile isolates.

Item Type: Article
Fakhre Yaseri, H.UNSPECIFIED
Moqarabzadeh, V.UNSPECIFIED
Amirmozafari, N.UNSPECIFIED
Keywords: Antimicrobial susceptibility testing Clostridium difficile Disc diffusion Iran Resistance
Page Range: pp. 28-33
Journal or Publication Title: Journal of Global Antimicrobial Resistance
Journal Index: Pubmed
Volume: 18
Identification Number:
ISSN: 2213-7173 (Electronic) 2213-7165 (Linking)
Depositing User: مهندس مهدی شریفی

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