Skip to main content

Advertisement

SpringerLink
Log in

Routine disc diffusion antimicrobial susceptibility testing of Clostridium difficile and association with PCR ribotype 027

  • Original Article
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Reduced susceptibility to metronidazole and vancomycin in Clostridium difficile has been reported, which emphasises the need for simple antimicrobial susceptibility testing methods. The aim of this study was to apply a published disc diffusion method and zone diameter breakpoint correlates to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) epidemiological minimum inhibitory concentration (MIC) cut-off values in a routine setting. Metronidazole and vancomycin zone diameters from 2702 isolates were recorded. Fifteen isolates had a metronidazole zone diameter below the published breakpoint (<23 mm) and five isolates had a vancomycin zone diameter below the published breakpoint (<19 mm), most of which were polymerase chain reaction (PCR) ribotype 027. The total number of PCR ribotype 027 was 29 (1.1 %). Overall, C. difficile PCR ribotype 027 isolates had smaller zone diameters than non-027 isolates. The disc diffusion method is very simple and inexpensive, and the published zone diameter breakpoints will detect C. difficile isolates with reduced susceptibility to metronidazole and vancomycin.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Bouza E (2012) Consequences of Clostridium difficile infection: understanding the healthcare burden. Clin Microbiol Infect 18(Suppl 6):5–12

    Article  PubMed  Google Scholar 

  2. Debast SB, Bauer MP, Kuijper EJ et al (2014) European Society of Clinical Microbiology and Infectious Diseases: update of the treatment guidance document for Clostridium difficile infection. Clin Microbiol Infect 20(Suppl 2):1–26

    Article  CAS  PubMed  Google Scholar 

  3. Brazier JS, Fawley W, Freeman J et al (2001) Reduced susceptibility of Clostridium difficile to metronidazole. J Antimicrob Chemother 48:741–742

    Article  CAS  PubMed  Google Scholar 

  4. Wong SS, Woo PC, Luk WK et al (1999) Susceptibility testing of Clostridium difficile against metronidazole and vancomycin by disk diffusion and Etest. Diagn Microbiol Infect Dis 34:1–6

    Article  CAS  PubMed  Google Scholar 

  5. Peláez T, Alcalá L, Alonso R et al (2002) Reassessment of Clostridium difficile susceptibility to metronidazole and vancomycin. Antimicrob Agents Chemother 46:1647–1650

    Article  PubMed Central  PubMed  Google Scholar 

  6. Baines SD, O’Connor R, Freeman J et al (2008) Emergence of reduced susceptibility to metronidazole in Clostridium difficile. J Antimicrob Chemother 62:1046–1052

    Article  CAS  PubMed  Google Scholar 

  7. Mutlu E, Wroe AJ, Sanchez-Hurtado K et al (2007) Molecular characterization and antimicrobial susceptibility patterns of Clostridium difficile strains isolated from hospitals in south-east Scotland. J Med Microbiol 56:921–929

    Article  CAS  PubMed  Google Scholar 

  8. Freeman J, Vernon J, Morris K et al (2015) Pan-European longitudinal surveillance of antibiotic resistance among prevalent Clostridium difficile ribotypes. Clin Microbiol Infect 21:248.e9–248.e16

    Article  CAS  Google Scholar 

  9. Erikstrup LT, Danielsen TK, Hall V et al (2012) Antimicrobial susceptibility testing of Clostridium difficile using EUCAST epidemiological cut-off values and disk diffusion correlates. Clin Microbiol Infect 18:E266–E272

    Article  CAS  PubMed  Google Scholar 

  10. de Boer RF, Wijma JJ, Schuurman T et al (2010) Evaluation of a rapid molecular screening approach for the detection of toxigenic Clostridium difficile in general and subsequent identification of the tcdC Delta117 mutation in human stools. J Microbiol Methods 83:59–65

    Article  PubMed  Google Scholar 

  11. Hoegh AM, Nielsen JB, Lester A et al (2012) A multiplex, internally controlled real-time PCR assay for detection of toxigenic Clostridium difficile and identification of hypervirulent strain 027/ST-1. Eur J Clin Microbiol Infect Dis 31:1073–1079

    Article  CAS  PubMed  Google Scholar 

  12. Justesen US, Erikstrup LT, Danielsen TK et al (2012) The Brucella blood agar disc diffusion antimicrobial susceptibility testing—reproducibility results for Clostridium difficile ATCC 700057. Clin Microbiol Infect 18(Suppl 3):S117–S118

    Google Scholar 

Download references

Conflict of interest

The authors declare no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Clinical Microbiology, Odense University Hospital, Winsloewparken 21, 2, 5000, Odense C, Denmark

    H. M. Holt, T. K. Danielsen & U. S. Justesen

Authors
  1. H. M. Holt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. K. Danielsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. U. S. Justesen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to U. S. Justesen.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Holt, H.M., Danielsen, T.K. & Justesen, U.S. Routine disc diffusion antimicrobial susceptibility testing of Clostridium difficile and association with PCR ribotype 027. Eur J Clin Microbiol Infect Dis 34, 2243–2246 (2015). https://doi.org/10.1007/s10096-015-2475-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-015-2475-x

Keywords

Search

Navigation