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Molecular characterization, toxin detection and resistance testing of human clinical Clostridium difficile isolates from Lebanon

Berger, Fabian K. and Rasheed, Sari S. and Araj, George F. and Mahfouz, Rami and Rimmani, Hussein H. and Karaoui, Walid R. and Sharara, Ala I. and Dbaibo, Ghassan and Becker, Sören L. and von Müller, Lutz and Bischoff, Markus and Matar, Ghassan M. and Gärtner, Barbara. (2018) Molecular characterization, toxin detection and resistance testing of human clinical Clostridium difficile isolates from Lebanon. International journal of medical microbiology, 308 (3). pp. 358-363.

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Official URL: https://edoc.unibas.ch/64646/

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Abstract

Clostridium (Clostridioides) difficile is the main cause for nosocomial diarrhoea in industrialised nations. Epidemiologic data on the pathogen's occurrence in other world regions are still scarce. In this context we characterized with phenotypic and molecular genetic methods C. difficile isolates stemming from hospitalised patients with diarrhoea in Lebanon. From 129 stool samples of symptomatic patients at a tertiary care University hospital in Lebanon, a total of 107 C. difficile strains were cultivated and underwent ribotyping, toxin gene detection and antibiotic resistance testing. Ribotype 014 (RT014, 16.8%) predominated, followed by RT002 (9.3%), RT106 (8.4%) and RT070 (6.5%). Binary toxin gene-positive isolates (RT023, RT078 and RT126) were rarely detected and RT027 was absent. Interestingly, within one isolate only the toxin A gene (tcdA) was detected. Multiple-locus variable-number tandem repeat analysis (MLVA) revealed strong strain diversity in most RTs. The isolates were sensitive to metronidazole and vancomycin, and only a small proportion of strains displayed resistance against moxifloxacin, rifampicin, and clarithromycin (5.6%, 1.9%, and 2.8%), respectively. The data indicate that the genetic strain composition of Lebanese strains differs markedly from the situation seen in Europe and North America. Especially the epidemic RTs seen in the latter regions were almost absent in Lebanon. Interestingly, most strains showed almost no resistance to commonly used antibiotics that are suspected to play a major role in the development of C. difficile infection, despite frequent use of these antibiotics in Lebanon. Thus, the role of antimicrobial resistance as a major driving force for infection development remains uncertain in this area.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Eco System Health Sciences > Health Impact Assessment (Utzinger)
UniBasel Contributors:Becker, Sören Leif
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Elsevier
ISSN:1438-4221
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:03 Jul 2018 10:39
Deposited On:03 Jul 2018 10:39

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