Molecular epidemiology and antimicrobial resistance patterns of Clostridioides difficile isolates in Algerian hospitals

Authors

  • Youcef Boudjelal Laboratory of Molecular Biology, Genomics and Bioinformatics, Department of Biology, Faculty of Nature and Life Sciences, University Hassiba Benbouali of Chlef, Algeria
  • Marcela Krutova Department of Medical Microbiology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
  • Abla Djebbar Laboratory of Molecular Biology, Genomics and Bioinformatics, Department of Biology, Faculty of Nature and Life Sciences, University Hassiba Benbouali of Chlef, Algeria
  • Mohammed Sebaihia Laboratory of Molecular Biology, Genomics and Bioinformatics, Department of Biology, Faculty of Nature and Life Sciences, University Hassiba Benbouali of Chlef, Algeria
  • Mohammed El Amine Bekara Laboratory of Molecular Biology, Genomics and Bioinformatics, Department of Biology, Faculty of Nature and Life Sciences, University Hassiba Benbouali of Chlef, Algeria
  • Samir Rouabhia Department of Internal Medicine, University hospital Touhami Benflis, Batna, Algeria
  • Jeanne Couturier National Reference Laboratory for C. difficile, Saint Antoine Hospital in Paris, AP-HP, France
  • Rabab Syed-Zaidi National Reference Laboratory for C. difficile, Saint Antoine Hospital in Paris, AP-HP, France
  • Frédéric Barbut European Society of Clinical Microbiology and Infectious Diseases (ESCMID) study group for Clostridioides difficile (ESGCD)

DOI:

https://doi.org/10.3855/jidc.16056

Keywords:

Clostridioides difficile, Algeria, ribotyping, MLST, antibiotic resistance, toxins

Abstract

Introduction: Clostridioides difficile is a major pathogen responsible for hospital-associated diarrhoea. This study investigated the molecular epidemiology and antibiotic resistance of C. difficile isolates in five Algerian hospitals.

Methodology: Between 2016 and 2019, faecal specimens were collected from in-patients and were cultured for C. difficile. Isolates were characterised by toxin genes detection, Polymerase Chain Reaction (PCR)-ribotyping, Multilocus Sequence Typing (MLST), antimicrobial susceptibility testing against a panel of antibiotics, and screened for antimicrobial resistance genes.

Results: Out of 300 patient stools tested, 18 (6%) were positive for C. difficile by culture, and were found to belong to 11 different ribotypes (RT) and 12 sequence types (ST): RT 085/ST39, FR 248/ST259, FR 111/ST48, RT 017/ST37, RT 014/ST2, RT 014/ST14, FR 247/new ST, RT 005/ST6, RT 029/ST16, RT 039/ST26, RT 056/ST34 and RT 446/ST58. MLST analysis assigned the isolates to two clades, 1 and 4. Clade 4 was more homogeneous, as it mainly included non-toxigenic isolates. Three toxin gene profiles were detected, two toxigenic, A+B+CDT- (33.3%) and A-B+CDT- (11%); and one non-toxigenic, A-B-CDT- (55.5%). All C. difficile isolates were susceptible to metronidazole, vancomycin and moxifloxacin.

Conclusions: Overall prevalence of C. difficile in our healthcare settings was 6%. Antibiotic resistance rates ranged from 72.2% (clindamycin) to 16.6% (tetracycline). This study highlighted a relatively high genetic diversity in term of ribotypes, sequence types, toxin and antibiotic resistance patterns, in the C. difficile isolates. Further larger studies are needed to assess the true extent of C. difficile infections in Algeria.

Author Biographies

Youcef Boudjelal, Laboratory of Molecular Biology, Genomics and Bioinformatics, Department of Biology, Faculty of Nature and Life Sciences, University Hassiba Benbouali of Chlef, Algeria

Laboratory of Molecular Biology, Genomics and Bioinformatics, Department of Biology, Faculty of Nature and Life Sciences, University Hassiba Benbouali of Chlef, Algeria

Abla Djebbar, Laboratory of Molecular Biology, Genomics and Bioinformatics, Department of Biology, Faculty of Nature and Life Sciences, University Hassiba Benbouali of Chlef, Algeria

Laboratory of Molecular Biology, Genomics and Bioinformatics, Department of Biology, Faculty of Nature and Life Sciences, University Hassiba Benbouali of Chlef, Algeria

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Published

2022-06-30

How to Cite

1.
Boudjelal Y, Krutova M, Djebbar A, Sebaihia M, Bekara MEA, Rouabhia S, Couturier J, Syed-Zaidi R, Barbut F (2022) Molecular epidemiology and antimicrobial resistance patterns of Clostridioides difficile isolates in Algerian hospitals. J Infect Dev Ctries 16:1055–1063. doi: 10.3855/jidc.16056

Issue

Vol. 16 No. 06: June 2022

Section

Original Articles

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