U.S.-Based national sentinel surveillance study for the epidemiology of clostridium difficile-associated diarrheal isolates and their susceptibility to fidaxomicin

D. R. Snydman, L. A. McDermott, N. V. Jacobus, C. Thorpe, S. Stone, S. G. Jenkins, E. J C Goldstein, Robin Patel, B. A. Forbes, S. Mirrett, S. Johnson, D. N. Gerding

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

In 2011 a surveillance study for the susceptibility to fidaxomicin and epidemiology of Clostridium difficile isolates in the United States was undertaken in seven geographically dispersed medical centers. This report encompasses baseline surveillance in 2011 and 2012 on 925 isolates. A convenience sample of C. difficile isolates or toxin positive stools from patients were referred to a central laboratory. Antimicrobial susceptibility was determined by agar dilution (CLSI M11-A8). Clinical and Laboratory Standards Institute (CLSI), Food and Drug Administration, or European Union of Clinical Antimicrobial Susceptibility Testing (EUCAST) breakpoints were applied where applicable. Toxin gene profiles were characterized by multiplex PCR on each isolate. A random sample of 322 strains, stratified by institution, underwent restriction endonuclease analysis (REA). The fidaxomicin MIC90 was 0.5 μg/ml for all isolates regardless of REA type or toxin gene profile, and all isolates were inhibited at ≤1.0 μg/ml. By REA typing, BI strains represented 25.5% of the isolates. The toxin gene profile of tcdA, tcdB, and cdtA/B positive with a tcdC 18-bp deletion correlated with BI REA group. Moxifloxacin and clindamycin resistance was increased among either BI or binary toxin-positive isolates. Metronidazole and vancomycin showed reduced susceptibility (EUCAST criteria) in these isolates. Geographic variations in susceptibility, REA group and binary toxin gene presence were observed. Fidaxomicin activity against C. difficile isolated in a national surveillance study did not change more than 1 year after licensure. This analysis provides baseline results for future comparisons.

Original languageEnglish (US)
Pages (from-to)6437-6443
Number of pages7
JournalAntimicrobial Agents and Chemotherapy
Volume59
Issue number10
DOIs
StatePublished - Oct 1 2015

Fingerprint

Sentinel Surveillance
Clostridium difficile
DNA Restriction Enzymes
Epidemiology
European Union
Genes
Clindamycin
Multiplex Polymerase Chain Reaction
Metronidazole
United States Food and Drug Administration
Vancomycin
Licensure
Agar
lipiarmycin

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology
  • Infectious Diseases

Cite this

U.S.-Based national sentinel surveillance study for the epidemiology of clostridium difficile-associated diarrheal isolates and their susceptibility to fidaxomicin. / Snydman, D. R.; McDermott, L. A.; Jacobus, N. V.; Thorpe, C.; Stone, S.; Jenkins, S. G.; Goldstein, E. J C; Patel, Robin; Forbes, B. A.; Mirrett, S.; Johnson, S.; Gerding, D. N.

In: Antimicrobial Agents and Chemotherapy, Vol. 59, No. 10, 01.10.2015, p. 6437-6443.

Research output: Contribution to journalArticle

Snydman, DR, McDermott, LA, Jacobus, NV, Thorpe, C, Stone, S, Jenkins, SG, Goldstein, EJC, Patel, R, Forbes, BA, Mirrett, S, Johnson, S & Gerding, DN 2015, 'U.S.-Based national sentinel surveillance study for the epidemiology of clostridium difficile-associated diarrheal isolates and their susceptibility to fidaxomicin', Antimicrobial Agents and Chemotherapy, vol. 59, no. 10, pp. 6437-6443. https://doi.org/10.1128/AAC.00845-15
Snydman, D. R. ; McDermott, L. A. ; Jacobus, N. V. ; Thorpe, C. ; Stone, S. ; Jenkins, S. G. ; Goldstein, E. J C ; Patel, Robin ; Forbes, B. A. ; Mirrett, S. ; Johnson, S. ; Gerding, D. N. / U.S.-Based national sentinel surveillance study for the epidemiology of clostridium difficile-associated diarrheal isolates and their susceptibility to fidaxomicin. In: Antimicrobial Agents and Chemotherapy. 2015 ; Vol. 59, No. 10. pp. 6437-6443.
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