Antibiotic resistance patterns, toxin profiles, and toxin gene expression levels among Clostridioides difficile PCR ribotypes isolated from patients scheduled for colonoscopy.

Sahar Sabour, Taher Azimi, Effat Abbasi Montazeri, Seyed Saeed Seyedian, Zahra Farshadzadeh, Mansour Amin

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Article in Molecular biology reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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6 authors.

Sahar SabourInfectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Taher AzimiDepartment of Bacteriology & Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Effat Abbasi MontazeriDepartment of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Seyed Saeed SeyedianAlimentary Tract Research Center, Clinical Sciences Research Institute, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Zahra FarshadzadehDepartment of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Mansour AminInfectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. amin-m@ajums.ac.ir.

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6 · The paper itself

Abstract

backgroundKnowledge of antimicrobial resistance patterns and C. difficile ribotypes is necessary for more effective treatment of C. difficile infection (CDI) in healthcare settings. METHODS AND

resultsA total of 180 stool samples were collected from patients who were referred to colonoscopy departments. The Minimum Inhibitory Concentration (MIC) of vancomycin, clindamycin, ciprofloxacin, and ampicillin / sulbactam against C. difficile isolates was determined by Liofilchem® MIC Test Strips. Moreover, the susceptibility of isolates to metronidazole was identified using the Disk Diffusion Method (DDM). The Polymerase Chain Reaction (PCR) assay was used to detect the toxin-encoding genes in C. difficile isolates. PCR ribotyping was performed on the toxin-positive C. difficile. The SYBR Green-based Quantitative Real-Time PCR was used to evaluate the relative expression levels of toxin-encoding genes. Overall, 34 (18.9%) isolates confirmed as C. difficile; from these, 26.5%, 35.3%, 35.3%, and 41.2% were positive for tcdA, tcdB, cdtA, and cdtB genes, respectively. Eight isolates were tcdB+/cdtA+/cdtB+, three isolates were tcdA+/tcdB+, and four isolates were tcdA+/cdtB+. Resistance to metronidazole and vancomycin was shown in 8.8% and 5.9% of isolates, respectively. The most frequent ribotypes were RT012 (38%) and RT001 (19%), respectively. tcdA gene expression was significantly high in ribotypes 001 (8.26 fold), 078 (6.35 fold), and 027 (7.65 fold). Moreover, the tcdB relative expression was significantly high in ribotypes 012 (4.75 fold) and 078 (14.45 fold).

conclusionsIncrease in the expression levels of toxin-encoding genes in RT027 and RT078 revealed that these ribotypes are hypervirulent and can cause severe infections in patients.

Indexed as

Bacterial ToxinsClostridioides difficileAgedAnti-Bacterial AgentsBacterial ProteinsClostridium InfectionsColonoscopyDrug Resistance, BacterialEnterotoxinsFecesFemaleHumansMaleMetronidazoleMicrobial Sensitivity TestsMiddle AgedAnti-Bacterial AgentsBacterial ProteinsBacterial ToxinsEnterotoxinsMetronidazoletcdA protein, Clostridium difficiletoxB protein, Clostridium difficileVancomycinAntibiotic resistanceClostridioides difficileColonoscopyEpidemiologyRibotypingToxin

Identifiers

PMID41460541

DOI10.1007/s10096-023-04665-y

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