TY - JOUR
T1 - Changes in molecular epidemiology and antimicrobial resistance profiles of Clostridioides (Clostridium) difficile strains in the United States between 2011 and 2017
AU - the HAI Consortium
AU - Tickler, Isabella A.
AU - Obradovich, Anne E.
AU - Goering, Richard V.
AU - Fang, Ferric C.
AU - Tenover, Fred C.
N1 - Funding Information:
I.A. Tickler and F.C. Tenover are employees of Cepheid, R.V. Goering has received research funding from Cepheid , and F.C. Fang has received consulting fees, educational grants and speaker honoraria from Cepheid. A.E. Obradovich has no conflicts to report. This study was funded by Cepheid.
Publisher Copyright:
© 2019 Elsevier Ltd
PY - 2019/12
Y1 - 2019/12
N2 - PCR ribotyping and antimicrobial susceptibility testing were used to characterize 940 Clostridioides (Clostridium) difficile isolates collected from 26 U S. hospitals over three time periods from 2011 to 2017. The proportion of ribotype (RT) 027 isolated during the three surveys decreased significantly over time from 31% in 2011–2012, to 22% in 2013–2014, and to 14% in 2015–2017 (p < 0.001 and p = 0.010, respectively), while we observed an increase in prevalence of RT106, that rose from 7% in our first survey to 19% of isolates in our last survey (p < 0.001). In addition, both RT056 and RT002 rose from 3% to 10% (p < 0.001). The proportions of all other ribotypes remained steady over time, and RT014/020 was the third most common strain type in our convenience sample in the final survey. Overall, resistance to moxifloxacin, rifampin, and vancomycin decreased during our studies, mainly due to the decline in RT027 isolates. A decrease in moxifloxacin resistance and an increase in tetracycline resistance were found among RT027 strains isolated in the last survey. Although the proportion of RT027 isolates declined, multidrug resistance among this ribotype continues to be common.
AB - PCR ribotyping and antimicrobial susceptibility testing were used to characterize 940 Clostridioides (Clostridium) difficile isolates collected from 26 U S. hospitals over three time periods from 2011 to 2017. The proportion of ribotype (RT) 027 isolated during the three surveys decreased significantly over time from 31% in 2011–2012, to 22% in 2013–2014, and to 14% in 2015–2017 (p < 0.001 and p = 0.010, respectively), while we observed an increase in prevalence of RT106, that rose from 7% in our first survey to 19% of isolates in our last survey (p < 0.001). In addition, both RT056 and RT002 rose from 3% to 10% (p < 0.001). The proportions of all other ribotypes remained steady over time, and RT014/020 was the third most common strain type in our convenience sample in the final survey. Overall, resistance to moxifloxacin, rifampin, and vancomycin decreased during our studies, mainly due to the decline in RT027 isolates. A decrease in moxifloxacin resistance and an increase in tetracycline resistance were found among RT027 strains isolated in the last survey. Although the proportion of RT027 isolates declined, multidrug resistance among this ribotype continues to be common.
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U2 - 10.1016/j.anaerobe.2019.06.003
DO - 10.1016/j.anaerobe.2019.06.003
M3 - Article
C2 - 31173889
AN - SCOPUS:85072584547
VL - 60
JO - Anaerobe
JF - Anaerobe
SN - 1075-9964
M1 - 102050
ER -