{"doi":"10.1099/jmm.0.46213-0","title":"Prevalence and association of PCR ribotypes of Clostridium difficile isolated from symptomatic patients from Warsaw with macrolide-lincosamide-streptogramin B (MLSB) type resistance","abstract":"<jats:p>Isolates (79 in total) of <jats:italic>Clostridium difficile</jats:italic> obtained over a 2 year period from 785 patients suspected of having <jats:italic>C. difficile</jats:italic>-associated diarrhoea (CDAD) and being hospitalized in the University Hospital in Warsaw were characterized by toxigenicity profile and PCR ribotyping. Furthermore, their susceptibility to clindamycin and erythromycin was determined. Among the 79 <jats:italic>C. difficile</jats:italic> isolates, 35 were classified as A<jats:sup>+</jats:sup>B<jats:sup>+</jats:sup>, 1 as A<jats:sup>+</jats:sup>B<jats:sup>+</jats:sup>CDT<jats:sup>+</jats:sup>, 36 as A<jats:sup>−</jats:sup>B<jats:sup>+</jats:sup> and 7 as A<jats:sup>−</jats:sup>B<jats:sup>−</jats:sup>. A total of 21 different PCR ribotypes was detected. Two main A<jats:sup>+</jats:sup>B<jats:sup>+</jats:sup> strains circulated in our hospital: ribotype 014 and ribotype 046. Unexpectedly, the predominant PCR ribotype was type 017, a known A<jats:sup>−</jats:sup>B<jats:sup>+</jats:sup> strain, and this accounted for about 45·5 % of all isolates cultured from patients with CDAD. Isolates belonging to PCR ribotype 017 were found in cases from epidemics of antibiotic-associated diarrhoea in the internal and surgery units. High-level resistance (MIC⩾256 mg l<jats:sup>−1</jats:sup>) to clindamycin and erythromycin was found in 39 (49 %) of the <jats:italic>C. difficile</jats:italic> isolates. Interestingly, 34 (94 %) of macrolide-lincosamide-streptogramin B (MLS<jats:sub>B</jats:sub>) type resistance strains did not produce toxin A, but produced toxin B and were A<jats:sup>−</jats:sup>B<jats:sup>+</jats:sup> ribotype 017. Thirty-seven of the high-level resistance strains harboured the erythromycin-resistance methylase gene (<jats:italic>ermB</jats:italic>). <jats:italic>C. difficile</jats:italic> isolates (2/29) that had high-level clindamycin and erythromycin resistance, and belonged to PCR ribotype 046, were <jats:italic>ermB</jats:italic> negative. These investigations revealed that the predominant <jats:italic>C. difficile</jats:italic> strain isolated from symptomatic patients hospitalized in University Hospital in Warsaw was MLS<jats:sub>B</jats:sub>-positive clindamycin/erythromycin-resistant PCR ribotype 017.</jats:p>","journal":"Journal of Medical Microbiology","year":2006,"id":647929,"datarank":3.9569936296503916,"base_score":3.9512437185814275,"endowment":3.9512437185814275,"self_citation_contribution":0.5926865577872142,"citation_network_contribution":3.3643070718631773,"self_endowment_contribution":0.5926865577872142,"citer_contribution":3.3643070718631773,"corpus_percentile":null,"corpus_rank":null,"citation_count":51,"citer_count":40,"citers_with_citation_signal":39,"citers_with_endowment":39,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1688265,"name":"Jon S. Brazier","orcid":null,"position":1,"is_corresponding":false},{"id":1688266,"name":"Piotr Obuch-Woszczatyński","orcid":null,"position":2,"is_corresponding":false},{"id":1688267,"name":"Dorota Wultańska","orcid":null,"position":3,"is_corresponding":false},{"id":1688268,"name":"Felicja Meisel-Mikołajczyk","orcid":null,"position":4,"is_corresponding":false},{"id":1688269,"name":"Mirosław Łuczak","orcid":null,"position":5,"is_corresponding":false},{"id":1639659,"name":"Hanna Pituch","orcid":"0000-0002-2348-4402","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Prevalence and association of PCR ribotypes of Clostridium difficile isolated from symptomatic patients from Warsaw with macrolide-lincosamide-streptogramin B (MLSB) type resistance","abstract":"<jats:p>Isolates (79 in total) of <jats:italic>Clostridium difficile</jats:italic> obtained over a 2 year period from 785 patients suspected of having <jats:italic>C. difficile</jats:italic>-associated diarrhoea (CDAD) and being hospitalized in the University Hospital in Warsaw were characterized by toxigenicity profile and PCR ribotyping. Furthermore, their susceptibility to clindamycin and erythromycin was determined. Among the 79 <jats:italic>C. difficile</jats:italic> isolates, 35 were classified as A<jats:sup>+</jats:sup>B<jats:sup>+</jats:sup>, 1 as A<jats:sup>+</jats:sup>B<jats:sup>+</jats:sup>CDT<jats:sup>+</jats:sup>, 36 as A<jats:sup>−</jats:sup>B<jats:sup>+</jats:sup> and 7 as A<jats:sup>−</jats:sup>B<jats:sup>−</jats:sup>. A total of 21 different PCR ribotypes was detected. Two main A<jats:sup>+</jats:sup>B<jats:sup>+</jats:sup> strains circulated in our hospital: ribotype 014 and ribotype 046. Unexpectedly, the predominant PCR ribotype was type 017, a known A<jats:sup>−</jats:sup>B<jats:sup>+</jats:sup> strain, and this accounted for about 45·5 % of all isolates cultured from patients with CDAD. Isolates belonging to PCR ribotype 017 were found in cases from epidemics of antibiotic-associated diarrhoea in the internal and surgery units. High-level resistance (MIC⩾256 mg l<jats:sup>−1</jats:sup>) to clindamycin and erythromycin was found in 39 (49 %) of the <jats:italic>C. difficile</jats:italic> isolates. Interestingly, 34 (94 %) of macrolide-lincosamide-streptogramin B (MLS<jats:sub>B</jats:sub>) type resistance strains did not produce toxin A, but produced toxin B and were A<jats:sup>−</jats:sup>B<jats:sup>+</jats:sup> ribotype 017. Thirty-seven of the high-level resistance strains harboured the erythromycin-resistance methylase gene (<jats:italic>ermB</jats:italic>). <jats:italic>C. difficile</jats:italic> isolates (2/29) that had high-level clindamycin and erythromycin resistance, and belonged to PCR ribotype 046, were <jats:italic>ermB</jats:italic> negative. These investigations revealed that the predominant <jats:italic>C. difficile</jats:italic> strain isolated from symptomatic patients hospitalized in University Hospital in Warsaw was MLS<jats:sub>B</jats:sub>-positive clindamycin/erythromycin-resistant PCR ribotype 017.</jats:p>","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"16434714","pmcid":null,"openalex_id":null,"authors":[],"funders":[],"total_grants":0,"fwci":null,"citation_percentile":null,"influential_citations":0,"citation_trend":[],"oa_status":"closed","license":null,"oa_locations":[{"url":"https://www.microbiologyresearch.org/content/journal/jmm/10.1099/jmm.0.46213-0?crawler=true","host_type":"publisher"}],"fields_of_study":[],"mesh_terms":["Humans","Enterocolitis, Pseudomembranous","Macrolides","Erythromycin","Clindamycin","Streptogramin B","Bacterial Toxins","Anti-Bacterial Agents","Ribotyping","Drug Resistance, Bacterial","Species Specificity","Hospitals, University","Poland","Lincosamides","Clostridioides difficile"],"keywords":[],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-10T02:02:37.335739Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}