Molecular epidemiology and antimicrobial resistance patterns of Clostridioides difficile isolates in Algerian hospitals

Introduction: Clostridioides difficile is a major pathogen responsible for hospital-associated diarrhoea. This study investigated the molecular epidemiology and antibiotic resistance of C. difficile isolates in five Algerian hospitals. Methodology: Between 2016 and 2019, faecal specimens were co...

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Main Authors: Youcef Boudjelal, Marcela Krutova, Abla Djebbar, Mohammed Sebaihia, Mohammed El Amine Bekara, Samir Rouabhia, Jeanne Couturier, Rabab Syed-Zaidi, Frédéric Barbut
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2022-06-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/16056
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author Youcef Boudjelal
Marcela Krutova
Abla Djebbar
Mohammed Sebaihia
Mohammed El Amine Bekara
Samir Rouabhia
Jeanne Couturier
Rabab Syed-Zaidi
Frédéric Barbut
author_facet Youcef Boudjelal
Marcela Krutova
Abla Djebbar
Mohammed Sebaihia
Mohammed El Amine Bekara
Samir Rouabhia
Jeanne Couturier
Rabab Syed-Zaidi
Frédéric Barbut
author_sort Youcef Boudjelal
collection DOAJ
description Introduction: Clostridioides difficile is a major pathogen responsible for hospital-associated diarrhoea. This study investigated the molecular epidemiology and antibiotic resistance of C. difficile isolates in five Algerian hospitals. Methodology: Between 2016 and 2019, faecal specimens were collected from in-patients and were cultured for C. difficile. Isolates were characterised by toxin genes detection, Polymerase Chain Reaction (PCR)-ribotyping, Multilocus Sequence Typing (MLST), antimicrobial susceptibility testing against a panel of antibiotics, and screened for antimicrobial resistance genes. Results: Out of 300 patient stools tested, 18 (6%) were positive for C. difficile by culture, and were found to belong to 11 different ribotypes (RT) and 12 sequence types (ST): RT 085/ST39, FR 248/ST259, FR 111/ST48, RT 017/ST37, RT 014/ST2, RT 014/ST14, FR 247/new ST, RT 005/ST6, RT 029/ST16, RT 039/ST26, RT 056/ST34 and RT 446/ST58. MLST analysis assigned the isolates to two clades, 1 and 4. Clade 4 was more homogeneous, as it mainly included non-toxigenic isolates. Three toxin gene profiles were detected, two toxigenic, A+B+CDT- (33.3%) and A-B+CDT- (11%); and one non-toxigenic, A-B-CDT- (55.5%). All C. difficile isolates were susceptible to metronidazole, vancomycin and moxifloxacin. Conclusions: Overall prevalence of C. difficile in our healthcare settings was 6%. Antibiotic resistance rates ranged from 72.2% (clindamycin) to 16.6% (tetracycline). This study highlighted a relatively high genetic diversity in term of ribotypes, sequence types, toxin and antibiotic resistance patterns, in the C. difficile isolates. Further larger studies are needed to assess the true extent of C. difficile infections in Algeria.
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spelling doaj-art-53ddd4d5014d4288bedde8084d1dc6452025-08-20T02:57:21ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802022-06-01160610.3855/jidc.16056Molecular epidemiology and antimicrobial resistance patterns of Clostridioides difficile isolates in Algerian hospitalsYoucef Boudjelal0Marcela Krutova1Abla Djebbar2Mohammed Sebaihia3Mohammed El Amine Bekara4Samir Rouabhia5Jeanne Couturier6Rabab Syed-Zaidi7Frédéric Barbut8Laboratory of Molecular Biology, Genomics and Bioinformatics, Department of Biology, Faculty of Nature and Life Sciences, University Hassiba Benbouali of Chlef, AlgeriaDepartment of Medical Microbiology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech RepublicLaboratory of Molecular Biology, Genomics and Bioinformatics, Department of Biology, Faculty of Nature and Life Sciences, University Hassiba Benbouali of Chlef, AlgeriaLaboratory of Molecular Biology, Genomics and Bioinformatics, Department of Biology, Faculty of Nature and Life Sciences, University Hassiba Benbouali of Chlef, AlgeriaLaboratory of Molecular Biology, Genomics and Bioinformatics, Department of Biology, Faculty of Nature and Life Sciences, University Hassiba Benbouali of Chlef, AlgeriaDepartment of Internal Medicine, University hospital Touhami Benflis, Batna, AlgeriaNational Reference Laboratory for C. difficile, Saint Antoine Hospital in Paris, AP-HP, FranceNational Reference Laboratory for C. difficile, Saint Antoine Hospital in Paris, AP-HP, FranceEuropean Society of Clinical Microbiology and Infectious Diseases (ESCMID) study group for Clostridioides difficile (ESGCD) Introduction: Clostridioides difficile is a major pathogen responsible for hospital-associated diarrhoea. This study investigated the molecular epidemiology and antibiotic resistance of C. difficile isolates in five Algerian hospitals. Methodology: Between 2016 and 2019, faecal specimens were collected from in-patients and were cultured for C. difficile. Isolates were characterised by toxin genes detection, Polymerase Chain Reaction (PCR)-ribotyping, Multilocus Sequence Typing (MLST), antimicrobial susceptibility testing against a panel of antibiotics, and screened for antimicrobial resistance genes. Results: Out of 300 patient stools tested, 18 (6%) were positive for C. difficile by culture, and were found to belong to 11 different ribotypes (RT) and 12 sequence types (ST): RT 085/ST39, FR 248/ST259, FR 111/ST48, RT 017/ST37, RT 014/ST2, RT 014/ST14, FR 247/new ST, RT 005/ST6, RT 029/ST16, RT 039/ST26, RT 056/ST34 and RT 446/ST58. MLST analysis assigned the isolates to two clades, 1 and 4. Clade 4 was more homogeneous, as it mainly included non-toxigenic isolates. Three toxin gene profiles were detected, two toxigenic, A+B+CDT- (33.3%) and A-B+CDT- (11%); and one non-toxigenic, A-B-CDT- (55.5%). All C. difficile isolates were susceptible to metronidazole, vancomycin and moxifloxacin. Conclusions: Overall prevalence of C. difficile in our healthcare settings was 6%. Antibiotic resistance rates ranged from 72.2% (clindamycin) to 16.6% (tetracycline). This study highlighted a relatively high genetic diversity in term of ribotypes, sequence types, toxin and antibiotic resistance patterns, in the C. difficile isolates. Further larger studies are needed to assess the true extent of C. difficile infections in Algeria. https://jidc.org/index.php/journal/article/view/16056Clostridioides difficileAlgeriaribotypingMLSTantibiotic resistancetoxins
spellingShingle Youcef Boudjelal
Marcela Krutova
Abla Djebbar
Mohammed Sebaihia
Mohammed El Amine Bekara
Samir Rouabhia
Jeanne Couturier
Rabab Syed-Zaidi
Frédéric Barbut
Molecular epidemiology and antimicrobial resistance patterns of Clostridioides difficile isolates in Algerian hospitals
Journal of Infection in Developing Countries
Clostridioides difficile
Algeria
ribotyping
MLST
antibiotic resistance
toxins
title Molecular epidemiology and antimicrobial resistance patterns of Clostridioides difficile isolates in Algerian hospitals
title_full Molecular epidemiology and antimicrobial resistance patterns of Clostridioides difficile isolates in Algerian hospitals
title_fullStr Molecular epidemiology and antimicrobial resistance patterns of Clostridioides difficile isolates in Algerian hospitals
title_full_unstemmed Molecular epidemiology and antimicrobial resistance patterns of Clostridioides difficile isolates in Algerian hospitals
title_short Molecular epidemiology and antimicrobial resistance patterns of Clostridioides difficile isolates in Algerian hospitals
title_sort molecular epidemiology and antimicrobial resistance patterns of clostridioides difficile isolates in algerian hospitals
topic Clostridioides difficile
Algeria
ribotyping
MLST
antibiotic resistance
toxins
url https://jidc.org/index.php/journal/article/view/16056
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