Isfahan University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
Molecular Epidemiology of Clostridium Difficile Infection in Iranian Hospitals Publisher Pubmed



Shoaei P1 ; Shojaei H2 ; Khorvash F1 ; Hosseini SM3 ; Ataei B4 ; Tavakoli H5 ; Jalali M6 ; Weese JS7
Authors
Show Affiliations
Authors Affiliations
  1. 1. Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Epidemiology and Biostatics Department, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  5. 5. Department of Biology, University of British Columbia, Kelowna, Canada
  6. 6. School of Food Science and Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran
  7. 7. Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Canada

Source: Antimicrobial Resistance and Infection Control Published:2019


Abstract

Background: Clostridium difficile infection (CDI) is known as one of the most important causes of nosocomial infections. The main objective of this study was to evaluate the presence of Clostridium difficile in the stool of hospitalized patients with diarrhea as well as in their environments. Methods: C. difficile isolates were characterized according to the presence of toxin genes and antibiotic resistance. Multilocus Sequence Typing Analysis (MLST) was applied for finding the genetic polymorphism and relationship among strain lineages. Results: A total of 821 samples (574 stools and 247 swabs) were collected between April 2015 and May 2017. The prevalence of C. difficile isolates was 28.6% (164/574) in patients and 19% (47/247) in swabs taken from medical devices, hands of healthcare workers and skin patient sites. Finally, 11.5% (66/574) toxigenic C. difficile strains isolated from stool samples of inpatients and 4.4% (11/247) from hands of healthcare workers and skin patient sites. All the toxigenic isolates were inhibited by a low concentration of vancomycin (MIC < 0.5 μg/ml). About 43% (33/77) and 39% of isolates were resistant to Clindamycin and moxifloxacin respectively. All isolates were susceptible to metronidazole. Toxigenic C. difficile strains were analyzed by MLST and were divided into 4 different STs. The detected types were ST-54 (57.9%), followed by ST-2 (31.6. %), ST-15 (5.3%) and ST-37 (5.3%), while none of the isolates were identified as ST-1 or ST-11. Significant risk factors for CDI appear to be advanced age, undergoing chemotherapy, previous surgery, and residence in the nursing home. Conclusions: CDI is common in Iran and further studies are recommended to monitor its epidemiological variations. Moreover, greater attempts must be made to encourage antibiotic stewardship by healthcare workers and the public. © 2019 The Author(s).
Related Docs
View other Related Docs
1. Clostridium Difficile Infection in Cancer Patients With Hospital Acquired Diarrhea at the Teaching Hospitals in Iran: Multilocus Sequence Typing Analysis (Mlst) and Antimicrobial Resistance Pattern, Annali di Igiene Medicina Preventiva e di Comunita (2019)
2. Phenotypic and Genotypic Characteristics of Clostridium Difficile Isolates in Patients With Type 2 Diabetes in Iran, Infection and Drug Resistance (2020)
3. Clostridium Difficile Isolated From Faecal Samples in Patients With Ulcerative Colitis, BMC Infectious Diseases (2019)
4. Gut Microbiota in Burned Patients With Clostridioides Difficile Infection, Burns (2022)
5. Burden of Clostridium Clostridioides Difficile Infection Among Patients in Western Asia: A Systematic Review and Meta-Analysis, Iranian Journal of Public Health (2019)
6. Clostridium Difficile Infection in an Iranian Hospital, BMC Research Notes (2012)
7. The Relative Frequency of Clostridium Difficile in Fecal Samples of Hospitalized Patients With Diarrhea by Elisa Method, Journal of Isfahan Medical School (2012)
8. Examining the Extent of Contamination, Antibiotic Resistance, and Genetic Diversity of Clostridioides (Clostridium) Difficile Strains in Meat and Feces of Some Native Birds of Iran, BioMed Research International (2023)
Experts (# of related papers)
View all Related Experts
Zahra Esfandiari (11)
Farzin Khorvash (5)
Other Related Docs
9. Prevalence of Clostridium Difficile in Raw Beef, Cow, Sheep, Goat, Camel and Buffalo Meat in Iran, BMC Public Health (2014)
10. Prevalence and Characterization of Clostridium Difficile in Beef and Mutton Meats of Isfahan Region, Iran, Jundishapur Journal of Microbiology (2014)
11. Prevalence and Risk Factors of Clostridium Difficile-Associated Diarrhea in Iranian Hospitalized Patients, Annals of Tropical Medicine and Public Health (2013)
12. Molecular Study of Clostridium Difficile Isolated From Beef in Isfahan, Iran, Journal of Veterinary Research (2016)
13. Molecular Characterization of Nosocomial Clostridium Difficile Infection in Pediatric Ward in Iran, SpringerPlus (2015)
14. Prevalence, Antibiotic Resistance, and Genetic Diversities of Clostridium Difficile in Meat Nuggets From Various Sources in Isfahan, Iran, Journal of Food Quality (2022)
15. Examination of the Prevalence, Genetic Diversity and Antibiotic Resistance of Clostridium Difficile (Clostridioides Difficile) in Semi-Cooked Ready-To-Eat Products in the Sale Centers of Isfahan Province, Iran, Journal of Health System Research (2024)
16. Clostridioides Difficile in Non-Hospital Sources (Animals, Food, and Environment) in Asian Countries: A Literature Review, Jundishapur Journal of Microbiology (2021)
17. Isolation and Characterization of Clostridium Difficile in Farm Animals From Slaughterhouse to Retail Stage in Isfahan, Iran, Foodborne Pathogens and Disease (2015)
18. A Review on Epidemiology of Clostridium Difficile Infection, Tehran University Medical Journal (2016)
19. Prevalence and Antibiotic Resistance of Clostridioides (Clostridium Difficile) in Meat and Meat Products: A Systematic Review and Meta-Analysis, Iranian Journal of Public Health (2023)
20. The Rate and Importance of Clostridium Difficile in Colorectal Cancer Patients, Gastroenterology and Hepatology from Bed to Bench (2019)
21. Occurrence of Clostridium Difficile in Two Types of Wastewater Treatment Plants, Journal of the Formosan Medical Association (2015)
22. Prevalence and Antibiotic Resistance Profile of Shiga Toxin-Producing Escherichia Coli Isolated From Diarrheal Samples, Iranian Journal of Microbiology (2020)
23. Considerable Rate of Putative Virulent Phylo-Groups in Fecal Carriage of Extended-Spectrum Β-Lactamase Producing Escherichia Coli, Infection, Genetics and Evolution (2019)
24. The Effectiveness of Synbiotics in Preventing Antibiotic-Associated Diarrhea in Children: A Double-Blind Randomized Clinical Trial, Archives of Pediatric Infectious Diseases (2019)
25. Molecular Characterization and Phage Typing of Methicillin-Resistant Staphylococcus Aureus Isolated From Clinical Samples in Isfahan, Iran, Jundishapur Journal of Microbiology (2023)
26. Bacillus Cereus in Infant Foods: Prevalence Study and Distribution of Enterotoxigenic Virulence Factors in Isfahan Province, Iran, The Scientific World Journal (2013)
27. A Pediatric Case of Antibiotic-Associated Hemorrhagic Colitis Caused by Klebsiella Oxytoca, International Journal of Preventive Medicine (2019)
28. Resistance to Antibiotics and Biocides and Prevalence of Qacab, Smr and Nora Genes in Vancomycin-Resistant Enterococci Isolated From Patients of Medical Education Centers in Isfahan, Iran, Journal of Isfahan Medical School (2023)
29. Molecular Detection of Clostridium Difficile in Patients With Diarrhea Via Lamp Technique, Journal of Mazandaran University of Medical Sciences (2014)
30. Molecular Characterization of Intestinal Carriage of Carbapenem-Resistant Enterobacteriaceae Among Inpatients at Two Iranian University Hospitals: First Report of Co-Production of Bla Ndm-7 and Bla Oxa-48, European Journal of Clinical Microbiology and Infectious Diseases (2017)
31. Phenotypic and Genotypic Characterization of Glycopeptide, Aminoglycoside and Macrolide Resistance Among Clinical Isolates of Enterococcus Faecalis: A Multicenter Based Study, BMC Research Notes (2019)
32. Detection of Genes Related to Linezolid Resistance (Poxta, Cfr, and Optra) in Clinical Isolates of Enterococcus Spp. From Humans: A First Report From Iran, Advanced Biomedical Research (2023)
33. Molecular Characterization of Vancomycin-Resistant Enterococcus Faecalis Among Inpatients at Iranian University Hospitals: Clonal Dissemination of St6 and St422, Infection and Drug Resistance (2019)
34. Prevalence and Genotyping of Methicillin-Resistant and – Susceptible Staphylococcus Aureus Strains Isolated From Patients in a University Hospital, Isfahan, Iran, Jundishapur Journal of Microbiology (2017)