Please use this identifier to cite or link to this item: doi:10.22028/D291-36547
Title: Molecular characterization, toxin detection and resistance testing of human clinical Clostridium difficile isolates from Lebanon
Author(s): Berger, Fabian K.
Rasheed, Sari S.
Araj, George F.
Mahfouz, Rami
Rimmani, Hussein H.
Karaoui, Walid R.
Sharara, Ala I.
Dbaibo, Ghassan
Becker, Sören L.
von Müller, Lutz
Bischoff, Markus
Matar, Ghassan M.
Gärtner, Barbara
Language: English
Title: International Journal of Medical Microbiology
Volume: 308
Issue: 3
Pages: 358-363
Publisher/Platform: Elsevier
Year of Publication: 2018
Free key words: Epidemiology
Middle East
DDC notations: 610 Medicine and health
Publikation type: Journal Article
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.
DOI of the first publication: 10.1016/j.ijmm.2018.01.004
URL of the first publication:
Link to this record: urn:nbn:de:bsz:291--ds-365477
ISSN: 1438-4221
Date of registration: 22-Jun-2022
Faculty: M - Medizinische Fakultät
Department: M - Infektionsmedizin
Professorship: M - Prof. Dr. Sören Becker
Collections:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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