AI Article Synopsis
- CDI (Clostridioides difficile infection) is a significant concern both in hospitals and in the community, leading to antibiotic-associated diarrhea and other gastrointestinal issues.
- A case study of a 30-year-old woman, who developed community acquired-CDI after antibiotic treatment for a cat bite, reveals the presence of hypervirulent bacterial strains tied to her condition.
- Analysis of bacterial isolates showed common toxin profiles and differentiated antibiotic resistance markers, highlighting the urgent need for monitoring CDI infections, especially those acquired outside of healthcare settings.
Article Abstract
Background: infection (CDI) leads to the onset of antibiotic-associated diarrhea (AAD) and a wide range of gastrointestinal pathologies. Currently, CDI is one of the most important opportunistic infections at the intrahospital level and an exponential increase in community-acquired infections has been reported. Herein, we evaluated the relationships (at phylogenetic and genetic population structure levels), as well as the molecular toxigenic and antibiotic resistance profiles of a set of isolates established from a case of community acquired-CDI.
Case Presentation: A 30-year-old woman with no history of hospitalization who was exposed to antibiotics (ampicillin/sulbactam and metronidazole) after a cat-bite wound was presented. The patient had a continuous episode of diarrhea; a stool sample was then collected and community acquired-CDI was confirmed by molecular tests and in vitro culture. Seven isolates were established and subsequently subjected to: (i) Multilocus sequence typing, all isolates belonging to ST-1 (associated with hypervirulent strain (027/BI/NAP1); (ii) description of their toxigenic profile: two of the isolates (Gcol.49 and Gcol.91) were positive for the genes coding for the major toxins ( and ) and their negative regulator (). All isolates were positive for the gene encoding one of the binary toxin subunits, while only two (Gcol.51 and Gcol.52) were positive for ; and (iii) identification of antibiotic resistance molecular markers, where there was no difference in or gene polymorphisms (related to quinolone resistance), but rather at loci presence/absence, being just one isolate negative, whereas the others showed a differential presence of the , and Tn916 regions. The former was associated with resistance to tetracycline and the other two for erythromycin/clindamycin.
Conclusions: This case represents the first report of community acquired-CDI in Colombia associated with hypervirulent strains and shows that isolates obtained from a single patient can carry different toxin and antibiotic resistance loci.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5680771 | PMC |
| http://dx.doi.org/10.1186/s13099-017-0212-y | DOI Listing |
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