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The C. difficile infection prevalence in South Africa in South Africa is concerning. Many strains that had been previously isolated from diarrhetic patients at Groote Schuur Hospital were ribotype 017. To identify all C. difficile isolates, a multilocus variable-number tandem-repeat analysis was used to characterize all C. difficile isolates. Both isolates were susceptible to vancomycin and metronidazole, but some ribotype 017 isolates had reduced metronidazole susceptibility, as shown by reduced metronidazole susceptibility. Sixty-nine percent of ribotype 017 isolates were resistant to moxifloxacin, and 94 percent to erythromycin, compared to 0 percent and 17 percent resistance, respectively in non-ribotype 017 isolates. Both erythromycin and moxifloxacin resistance were attributed to the ermB gene and mutations in the gyrA and/or gyrB genes. Auto-aggregated more frequently than other isolates and yielded lower TcdB toxin levels than a reference strain, with greater TcdB toxin content and lower TcdB toxin content than a reference strain. Patients-to-patient transfer and specific infection conditions could play a role in the predominance of ribotype 017 strains in the cohort.
Source link: https://doi.org/10.1007/s10096-016-2717-6
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