Abstract
We investigated the molecular characteristics and antimicrobial susceptibility of Clostridium difficile isolated from animals in China. We obtained 538 rectal swabs from pigs, chickens and ducks in 5 provinces during 2015 and 2016. C. difficile isolates were characterized by detection of toxin genes, multilocus sequence typing and ribotyping. And antimicrobial susceptibility testing was performed using the agar dilution method. Out of 538 samples, 44 (8.2%) were C. difficile positive with high prevalence in pigs (n = 31). Among these, 39 (88.6%) were toxigenic including 14 (31.8%) that were A+B+CDT+ and 13 (29.5%) A+B+. The remaining 12 (27.3%) were A-B+. We identified 7 ST types and 6 PCR ribotypes. The most predominant type was ST11/RT078 with toxin profile A+B+CDT+ and all were isolated from piglets with diarrhea. ST109 isolates possessed two different toxigenic profiles (A-B-CDT- and A-B+CDT-) and although it was not the most prevalent sequence type, but it was widely distributed between chickens, ducks and pigs in the 5 provinces. All C. difficile isolates were fully susceptible to vancomycin, metronidazole, fidaxomicin, amoxicillin/clavulanate and meropenem but retained resistance to 4 or 5 of the remaining antibiotics, especially cefotaxime, tetracycline, ciprofloxacin, cefoxitin. The RT078/ST11 isolates were simultaneously resistant to cefotaxime, tetracycline, cefoxitin, ciprofloxacin and imipenem. This is the first report of the molecular epidemiology of C. difficile isolated from food animals in China. We identified the epidemic strain RT078/ST11 as the predominate isolate among the animals we screened in our study.
Highlights
Clostridium difficile is a strictly anaerobic, spore-forming Gram-positive bacterium that colonizes the gastrointestinal tract of humans and animals and cause disease [1]
This study indicated that asymptomatic farmers and their pigs can be colonized with clonal C. difficile RT078 [17]
The present study is the first report of hypervirulent strain RT078/ST11 strain from piglets in China
Summary
Clostridium difficile is a strictly anaerobic, spore-forming Gram-positive bacterium that colonizes the gastrointestinal tract of humans and animals and cause disease [1]. C. difficile has emerged as the most common infectious cause of antibiotic-associated diarrhea and healthcare infections in developed countries This is due to the emergence of hypervirulent strain, restriction endonuclease analysis type BI, North American pulsed field type 1 and PCR ribotype 027 (BI/NAP1/027) [1]. This strain produces toxins A, B and binary toxin CDT (A+B+CDT+) and possesses increased fluoroquinolone resistance and has been responsible for C. difficile infections (CDI) and outbreaks in North America, Canada and Europe since 2000 [3,4,5,6]. RT027 remains prevalent in North America and Europe,another PCR ribotype 078 is emerging as a significant human pathogen [7, 8]
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