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Characterization of Clostridioides difficile Strains from an Outbreak Using MALDI-TOF Mass Spectrometry

The epidemiology of Clostridioides difficile infection (CDI) has changed over the last two decades, due to the emergence of C. difficile strains with clinical relevance and responsible for nosocomial outbreaks with severe outcomes. This study reports an outbreak occurred in a Long-term Care Unit fro...

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Autores principales: Calderaro, Adriana, Buttrini, Mirko, Farina, Benedetta, Montecchini, Sara, Martinelli, Monica, Arcangeletti, Maria Cristina, Chezzi, Carlo, De Conto, Flora
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9320467/
https://www.ncbi.nlm.nih.gov/pubmed/35889196
http://dx.doi.org/10.3390/microorganisms10071477
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author Calderaro, Adriana
Buttrini, Mirko
Farina, Benedetta
Montecchini, Sara
Martinelli, Monica
Arcangeletti, Maria Cristina
Chezzi, Carlo
De Conto, Flora
author_facet Calderaro, Adriana
Buttrini, Mirko
Farina, Benedetta
Montecchini, Sara
Martinelli, Monica
Arcangeletti, Maria Cristina
Chezzi, Carlo
De Conto, Flora
author_sort Calderaro, Adriana
collection PubMed
description The epidemiology of Clostridioides difficile infection (CDI) has changed over the last two decades, due to the emergence of C. difficile strains with clinical relevance and responsible for nosocomial outbreaks with severe outcomes. This study reports an outbreak occurred in a Long-term Care Unit from February to March 2022 and tracked by using a Matrix-Assisted Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) typing approach (T-MALDI); subsequently, a characterization of the toxigenic and antimicrobial susceptibility profiles of the C. difficile isolates was performed. A total of 143 faecal samples belonging to 112 patients was evaluated and C. difficile DNA was detected in 51 samples (46 patients). Twenty-nine C. difficile isolates were obtained, and three different clusters were revealed by T-MALDI. The most representative cluster accounted 22 strains and was considered to be epidemic, in agreement with PCR-Ribotyping. Such epidemic strains were susceptible to vancomycin (MIC ≤ 0.5 mg/mL) and metronidazole (MIC ≤ 1 mg/mL), but not to moxifloxacin (MIC > 32 mg/mL). Moreover, they produced only the Toxin A and, additionally, the binary toxin. To our knowledge, this is the first reported outbreak referable to a tcdA+/tcdB-/cdt+ genotypic profile. In light of these results, T-MALDI is a valid and rapid approach for discovering and tracking outbreaks.
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spelling pubmed-93204672022-07-27 Characterization of Clostridioides difficile Strains from an Outbreak Using MALDI-TOF Mass Spectrometry Calderaro, Adriana Buttrini, Mirko Farina, Benedetta Montecchini, Sara Martinelli, Monica Arcangeletti, Maria Cristina Chezzi, Carlo De Conto, Flora Microorganisms Article The epidemiology of Clostridioides difficile infection (CDI) has changed over the last two decades, due to the emergence of C. difficile strains with clinical relevance and responsible for nosocomial outbreaks with severe outcomes. This study reports an outbreak occurred in a Long-term Care Unit from February to March 2022 and tracked by using a Matrix-Assisted Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) typing approach (T-MALDI); subsequently, a characterization of the toxigenic and antimicrobial susceptibility profiles of the C. difficile isolates was performed. A total of 143 faecal samples belonging to 112 patients was evaluated and C. difficile DNA was detected in 51 samples (46 patients). Twenty-nine C. difficile isolates were obtained, and three different clusters were revealed by T-MALDI. The most representative cluster accounted 22 strains and was considered to be epidemic, in agreement with PCR-Ribotyping. Such epidemic strains were susceptible to vancomycin (MIC ≤ 0.5 mg/mL) and metronidazole (MIC ≤ 1 mg/mL), but not to moxifloxacin (MIC > 32 mg/mL). Moreover, they produced only the Toxin A and, additionally, the binary toxin. To our knowledge, this is the first reported outbreak referable to a tcdA+/tcdB-/cdt+ genotypic profile. In light of these results, T-MALDI is a valid and rapid approach for discovering and tracking outbreaks. MDPI 2022-07-21 /pmc/articles/PMC9320467/ /pubmed/35889196 http://dx.doi.org/10.3390/microorganisms10071477 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Calderaro, Adriana
Buttrini, Mirko
Farina, Benedetta
Montecchini, Sara
Martinelli, Monica
Arcangeletti, Maria Cristina
Chezzi, Carlo
De Conto, Flora
Characterization of Clostridioides difficile Strains from an Outbreak Using MALDI-TOF Mass Spectrometry
title Characterization of Clostridioides difficile Strains from an Outbreak Using MALDI-TOF Mass Spectrometry
title_full Characterization of Clostridioides difficile Strains from an Outbreak Using MALDI-TOF Mass Spectrometry
title_fullStr Characterization of Clostridioides difficile Strains from an Outbreak Using MALDI-TOF Mass Spectrometry
title_full_unstemmed Characterization of Clostridioides difficile Strains from an Outbreak Using MALDI-TOF Mass Spectrometry
title_short Characterization of Clostridioides difficile Strains from an Outbreak Using MALDI-TOF Mass Spectrometry
title_sort characterization of clostridioides difficile strains from an outbreak using maldi-tof mass spectrometry
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9320467/
https://www.ncbi.nlm.nih.gov/pubmed/35889196
http://dx.doi.org/10.3390/microorganisms10071477
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