Prevalence and association of macrolide-lincosamide-streptogramin B (MLSB) resistance with resistance to moxifloxacin in Clostridium difficile

Grit Ackermann, Angelika Degner, Stuart H Cohen, Joseph Silva, Arne C. Rodloff

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

Clostridium difficile remains the leading cause of nosocomially acquired diarrhoea. C. difficile usually exhibits resistance against β-lactam antibiotics, whereas susceptibility to other drugs may vary. This study investigated the antimicrobial susceptibility of C. difficile to different antibiotics over a period of time and characterizes molecular mechanisms for resistance. One hundred and seventy-three toxigenic and 19 non-toxigenic C. difficile strains, recovered from patients in two university hospitals in Germany between 1986 and 2001, were investigated for their susceptibility to erythromycin, clindamycin, moxifloxacin, vancomycin and metronidazole employing the Etest. The genetic background for resistance was analysed using PCR and DNA sequencing. All strains were susceptible to vancomycin and metronidazole. Resistance to erythromycin, clindamycin and moxifloxacin was found in 27%, 36% and 12% of the tested strains, respectively. High-level resistance (MIC > 128 mg/L) against erythromycin and clindamycin was detected in 25% of the strains tested. Thirty-four of the macrolide-lincosamide-streptogramin B (MLSB)-resistant strains carried the erythromycin resistance methylase gene. The results indicate an increase in the prevalence of resistance to MLSB and fluoroquinolone antibiotics in C. difficile. Fluoroquinolone resistance is associated with resistance to MLSB antimicrobials.

Original languageEnglish (US)
Pages (from-to)599-603
Number of pages5
JournalJournal of Antimicrobial Chemotherapy
Volume51
Issue number3
DOIs
StatePublished - Mar 1 2003

Fingerprint

Streptogramin B
Lincosamides
Clostridium difficile
Macrolides
Erythromycin
Clindamycin
Fluoroquinolones
Metronidazole
Vancomycin
Anti-Bacterial Agents
Disk Diffusion Antimicrobial Tests
Lactams
DNA Sequence Analysis
Germany
Diarrhea
moxifloxacin
Polymerase Chain Reaction
Pharmaceutical Preparations
Genes

Keywords

  • Antimicrobials
  • Clostridium difficile
  • Susceptibility

ASJC Scopus subject areas

  • Pharmacology
  • Microbiology

Cite this

Prevalence and association of macrolide-lincosamide-streptogramin B (MLSB) resistance with resistance to moxifloxacin in Clostridium difficile. / Ackermann, Grit; Degner, Angelika; Cohen, Stuart H; Silva, Joseph; Rodloff, Arne C.

In: Journal of Antimicrobial Chemotherapy, Vol. 51, No. 3, 01.03.2003, p. 599-603.

Research output: Contribution to journalArticle

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abstract = "Clostridium difficile remains the leading cause of nosocomially acquired diarrhoea. C. difficile usually exhibits resistance against β-lactam antibiotics, whereas susceptibility to other drugs may vary. This study investigated the antimicrobial susceptibility of C. difficile to different antibiotics over a period of time and characterizes molecular mechanisms for resistance. One hundred and seventy-three toxigenic and 19 non-toxigenic C. difficile strains, recovered from patients in two university hospitals in Germany between 1986 and 2001, were investigated for their susceptibility to erythromycin, clindamycin, moxifloxacin, vancomycin and metronidazole employing the Etest. The genetic background for resistance was analysed using PCR and DNA sequencing. All strains were susceptible to vancomycin and metronidazole. Resistance to erythromycin, clindamycin and moxifloxacin was found in 27{\%}, 36{\%} and 12{\%} of the tested strains, respectively. High-level resistance (MIC > 128 mg/L) against erythromycin and clindamycin was detected in 25{\%} of the strains tested. Thirty-four of the macrolide-lincosamide-streptogramin B (MLSB)-resistant strains carried the erythromycin resistance methylase gene. The results indicate an increase in the prevalence of resistance to MLSB and fluoroquinolone antibiotics in C. difficile. Fluoroquinolone resistance is associated with resistance to MLSB antimicrobials.",
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