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

Daniel R Knight, Steven Giglio, Peter G Huntington, Tony Korman, Despina Kotsanas, Casey V Moore, David L Paterson, Louise Prendergast, Charlotte Huber, Jennifer M Robson, Lynette Waring, Michael C Wehrhahn, Gerhard F Weldhagen, Richard M Wilson, Thomas Victor Riley

Research output: Contribution to journalArticleResearchpeer-review

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 whichwere 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. ? The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
Original languageEnglish
Pages (from-to)2992 - 2999
Number of pages8
JournalJournal of Antimicrobial Chemotherapy
Volume70
Issue number11
DOIs
Publication statusPublished - 2015

Cite this

Knight, D. R., Giglio, S., Huntington, P. G., Korman, T., Kotsanas, D., Moore, C. V., ... Riley, T. V. (2015). Surveillance for antimicrobial resistance in Australian isolates of Clostridium difficile, 2013-14. Journal of Antimicrobial Chemotherapy, 70(11), 2992 - 2999. https://doi.org/10.1093/jac/dkv220
Knight, Daniel R ; Giglio, Steven ; Huntington, Peter G ; Korman, Tony ; Kotsanas, Despina ; Moore, Casey V ; Paterson, David L ; Prendergast, Louise ; Huber, Charlotte ; Robson, Jennifer M ; Waring, Lynette ; Wehrhahn, Michael C ; Weldhagen, Gerhard F ; Wilson, Richard M ; Riley, Thomas Victor. / Surveillance for antimicrobial resistance in Australian isolates of Clostridium difficile, 2013-14. In: Journal of Antimicrobial Chemotherapy. 2015 ; Vol. 70, No. 11. pp. 2992 - 2999.
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title = "Surveillance for antimicrobial resistance in Australian isolates of Clostridium difficile, 2013-14",
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 whichwere 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. ? The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.",
author = "Knight, {Daniel R} and Steven Giglio and Huntington, {Peter G} and Tony Korman and Despina Kotsanas and Moore, {Casey V} and Paterson, {David L} and Louise Prendergast and Charlotte Huber and Robson, {Jennifer M} and Lynette Waring and Wehrhahn, {Michael C} and Weldhagen, {Gerhard F} and Wilson, {Richard M} and Riley, {Thomas Victor}",
year = "2015",
doi = "10.1093/jac/dkv220",
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Knight, DR, Giglio, S, Huntington, PG, Korman, T, Kotsanas, D, Moore, CV, Paterson, DL, Prendergast, L, Huber, C, Robson, JM, Waring, L, Wehrhahn, MC, Weldhagen, GF, Wilson, RM & Riley, TV 2015, 'Surveillance for antimicrobial resistance in Australian isolates of Clostridium difficile, 2013-14' Journal of Antimicrobial Chemotherapy, vol. 70, no. 11, pp. 2992 - 2999. https://doi.org/10.1093/jac/dkv220

Surveillance for antimicrobial resistance in Australian isolates of Clostridium difficile, 2013-14. / Knight, Daniel R; Giglio, Steven; Huntington, Peter G; Korman, Tony; Kotsanas, Despina; Moore, Casey V; Paterson, David L; Prendergast, Louise; Huber, Charlotte; Robson, Jennifer M; Waring, Lynette; Wehrhahn, Michael C; Weldhagen, Gerhard F; Wilson, Richard M; Riley, Thomas Victor.

In: Journal of Antimicrobial Chemotherapy, Vol. 70, No. 11, 2015, p. 2992 - 2999.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Surveillance for antimicrobial resistance in Australian isolates of Clostridium difficile, 2013-14

AU - Knight, Daniel R

AU - Giglio, Steven

AU - Huntington, Peter G

AU - Korman, Tony

AU - Kotsanas, Despina

AU - Moore, Casey V

AU - Paterson, David L

AU - Prendergast, Louise

AU - Huber, Charlotte

AU - Robson, Jennifer M

AU - Waring, Lynette

AU - Wehrhahn, Michael C

AU - Weldhagen, Gerhard F

AU - Wilson, Richard M

AU - Riley, Thomas Victor

PY - 2015

Y1 - 2015

N2 - 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 whichwere 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. ? The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.

AB - 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 whichwere 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. ? The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.

UR - http://jac.oxfordjournals.org/content/70/11/2992.full.pdf

U2 - 10.1093/jac/dkv220

DO - 10.1093/jac/dkv220

M3 - Article

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EP - 2999

JO - Journal of Antimicrobial Chemotherapy

JF - Journal of Antimicrobial Chemotherapy

SN - 0305-7453

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