Molecular, microbiological and clinical characterization of Clostridium difficile isolates from tertiary care hospitals in Colombia

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dc.contributor.authorSalazar, C.L.
dc.contributor.authorReyes, C.
dc.contributor.authorAtehortua, S.
dc.contributor.authorSierra, P.
dc.contributor.authorCorrea, M.M.
dc.contributor.authorParedes-Sabja, D.
dc.contributor.authorBest, E.
dc.contributor.authorFawley, W.N.
dc.contributor.authorWilcox, M.
dc.contributor.authorGonzález, Á.
dc.date.accessioned2018-03-13T15:37:01Z
dc.date.available2018-03-13T15:37:01Z
dc.date.issued2017-09
dc.descriptionIndexación: Scopus.es_ES
dc.description.abstractIn Colombia, the epidemiology and circulating genotypes of Clostridium difficile have not yet been described. Therefore, we molecularly characterized clinical isolates of C.difficile from patients with suspicion of C.difficile infection (CDI) in three tertiary care hospitals. C.difficile was isolated from stool samples by culture, the presence of A/B toxins were detected by enzyme immunoassay, cytotoxicity was tested by cell culture and the antimicrobial susceptibility determined. After DNA extraction, tcdA, tcdB and binary toxin (CDTa/CDTb) genes were detected by PCR, and PCR-ribotyping performed. From a total of 913 stool samples collected during 2013–2014, 775 were included in the study. The frequency of A/B toxins-positive samples was 9.7% (75/775). A total of 143 isolates of C.difficile were recovered from culture, 110 (76.9%) produced cytotoxic effect in cell culture, 100 (69.9%) were tcdA +/tcdB+, 11 (7.7%) tcdA-/tcdB+, 32 (22.4%) tcdA-/tcdB- and 25 (17.5%) CDTa+/CDTb+. From 37 ribotypes identified, ribotypes 591 (20%), 106 (9%) and 002 (7.9%) were the most prevalent; only one isolate corresponded to ribotype 027, four to ribotype 078 and four were new ribotypes (794,795, 804,805). All isolates were susceptible to vancomycin and metronidazole, while 85% and 7.7% were resistant to clindamycin and moxifloxacin, respectively. By multivariate analysis, significant risk factors associated to CDI were, staying in orthopedic service, exposure to third-generation cephalosporins and staying in an ICU before CDI symptoms; moreover, steroids showed to be a protector factor. These results revealed new C. difficile ribotypes and a high diversity profile circulating in Colombia different from those reported in America and European countries. © 2017 Salazar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.es_ES
dc.description.urihttp://journals.plos.org/plosone/article?id=10.1371/journal.pone.0184689
dc.identifier.citationPLoS ONE. Volume 12, Issue 9, September 2017, Article number e0184689es_ES
dc.identifier.issn1932-6203
dc.identifier.otherDOI: 10.1371/journal.pone.0184689
dc.identifier.urihttp://repositorio.unab.cl/xmlui/handle/ria/5428
dc.language.isoenes_ES
dc.publisherPublic Library of Sciencees_ES
dc.rights.licenseAttribution 4.0 International (CC BY 4.0)
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectAgedes_ES
dc.subjectBacterial Proteinses_ES
dc.subjectBacterial Toxinses_ES
dc.subjectClostridium difficilees_ES
dc.subjectColombiaes_ES
dc.subjectCross-Sectional Studieses_ES
dc.subjectEnterocolitis, Pseudomembranouses_ES
dc.subjectEnterotoxinses_ES
dc.subjectFemalees_ES
dc.subjectHumanses_ES
dc.subjectMalees_ES
dc.subjectMicrobial Sensitivity Testses_ES
dc.subjectMiddle Agedes_ES
dc.subjectRibotypinges_ES
dc.subjectRiskes_ES
dc.subjectFactorses_ES
dc.subjectTertiary Care Centerses_ES
dc.titleMolecular, microbiological and clinical characterization of Clostridium difficile isolates from tertiary care hospitals in Colombiaes_ES
dc.typeArtículoes_ES
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