Surveillance for antimicrobial resistance in Australian isolates of Clostridium difficile, 2013–14

Knight, Daniel R., Giglio, Steven, Huntington, Peter G., Korman, Tony M., Kotsanas, Despina, Moore, Casey V., Paterson, David L., Prendergast, Louise, Huber, Charlotte A., Robson, Jennifer, Waring, Lynette, Wehrhahn, Michael C., Weldhagen, Gerhard F., Wilson, Richard M. and Riley, Thomas V. (2015) Surveillance for antimicrobial resistance in Australian isolates of Clostridium difficile, 2013–14. Journal of Antimicrobial Chemotherapy, 70 11: 2992-2999. doi:10.1093/jac/dkv220

Author Knight, Daniel R.
Giglio, Steven
Huntington, Peter G.
Korman, Tony M.
Kotsanas, Despina
Moore, Casey V.
Paterson, David L.
Prendergast, Louise
Huber, Charlotte A.
Robson, Jennifer
Waring, Lynette
Wehrhahn, Michael C.
Weldhagen, Gerhard F.
Wilson, Richard M.
Riley, Thomas V.
Title Surveillance for antimicrobial resistance in Australian isolates of Clostridium difficile, 2013–14
Journal name Journal of Antimicrobial Chemotherapy   Check publisher's open access policy
ISSN 1460-2091
Publication date 2015-07-28
Year available 2015
Sub-type Article (original research)
DOI 10.1093/jac/dkv220
Open Access Status Not yet assessed
Volume 70
Issue 11
Start page 2992
End page 2999
Total pages 8
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Collection year 2016
Language eng
Formatted abstract
Objectives: The objective of this study was to determine the activity of fidaxomicin and comparator antimicrobials against Clostridium difficile isolated from patients with C. difficile infection (CDI) in Australian hospitals and in the community.

Methods: One private and one public laboratory from five states in Australia submitted a total of 474 isolates/PCR-positive stool samples during three collection periods in August–September 2013 (n = 175), February–March 2014 (n = 134) and August–September 2014 (n = 165). Isolate identification was confirmed by selective culture for C. difficile and a proportion of isolates from each state were characterized by PCR for toxin genes and PCR ribotyping. MICs of fidaxomicin and eight comparator antimicrobials were determined for all isolates using agar methodology.

Results: Site collection yielded 440 isolates of C. difficile and PCR revealed a heterogeneous strain population comprising 37 different PCR ribotypes (RTs), 95% of which were positive for tcdA and tcdB (A+B+). The most common RTs were 014 (29.8%) and 002 (15.9%). Epidemic RT 027 was not identified; however, small numbers of virulent RTs 078 and 244 were found. Resistance to vancomycin, metronidazole and fidaxomicin was not detected and resistance to moxifloxacin was very low (3.4%). Fidaxomicin showed potent in vitro activity against all 440 isolates (MIC50/MIC90 0.03/0.12 mg/L) and was superior to metronidazole (MIC50/MIC90 0.25/0.5 mg/L) and vancomycin (MIC50/MIC90 1/2 mg/L).

Conclusions: These data confirm the potent in vitro activity of fidaxomicin against C. difficile. Moreover, this study provides an important baseline for ongoing long-term surveillance of antimicrobial resistance and prospective tracking of prominent and emerging strain types.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
Official 2016 Collection
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Citation counts: TR Web of Science Citation Count  Cited 4 times in Thomson Reuters Web of Science Article | Citations
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Created: Tue, 17 Nov 2015, 14:22:56 EST by Ms Charlotte Huber on behalf of UQ Centre for Clinical Research