Please use this identifier to cite or link to this item: doi:10.22028/D291-36532
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Title: Hospital outbreak due to Clostridium difficile ribotype 018 (RT018) in Southern Germany
Author(s): Berger, Fabian K.
Gfrörer, Sabine
Becker, Sören L.
Baldan, Rossella
Cirillo, Daniela Maria
Frentrup, Martinique
Steglich, Matthias
Engling, Pit
Nübel, Ulrich
Mellmann, Alexander
Bischoff, Markus
Gärtner, Barbara
von Müller, Lutz
Language: English
Title: International Journal of Medical Microbiology
Volume: 309
Issue: 3-4
Pages: 189-193
Publisher/Platform: Elsevier
Year of Publication: 2019
Free key words: Epidemiology
Resistance testing
Antibiotic susceptibility
DDC notations: 610 Medicine and health
Publikation type: Journal Article
Abstract: Clostridium (Clostridioides) difficile is the main cause of nosocomial diarrhoea. Ribotype 018 (RT018) has been recognized as the predominant strain responsible for C. difficile infection (CDI) in Italy, whereas in most other European countries only sporadic RT018 cases occur. Between August and October 2015, a suspected C. difficile outbreak at two associated hospitals in Southern Germany was investigated by comprehensive molecular typing. Surprisingly, RT018 was detected in 9/82 CDI patients, which has never been described before in a German outbreak. Phenotypic analysis revealed fluoroquinolone and macrolide resistance. Genetic subtyping using multiple-locus variable-number tandem-repeat analysis (MLVA) and whole genome sequencing (WGS) was performed and outbreak isolates were directly compared to sporadic German RT018 isolates and to epidemic ones from Milan, Northern Italy. Molecular typing confirmed a hospital outbreak with closely related RT018 isolates. Both, MLVA and WGS revealed high similarity of outbreak strains with epidemic isolates from Italy, but low similarity to other German isolates. Comparison between both typing strategies showed that ribotyping in combination with MLVA was appropriate to identify related isolates and clonal complexes, whereas WGS provided a better discrimination with more detailed information about the phylogenetic relationship of isolates. This is the first hospital outbreak in Germany presumably caused by cross-national transmission of an Italian epidemic RT018 strain.
DOI of the first publication: 10.1016/j.ijmm.2019.03.001
URL of the first publication:
Link to this record: urn:nbn:de:bsz:291--ds-365329
ISSN: 1438-4221
Date of registration: 21-Jun-2022
Faculty: M - Medizinische Fakultät
Department: M - Infektionsmedizin
Professorship: M - Prof. Dr. Sören Becker
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