Clostridioides difficile: Characterization of the circulating toxinotypes in an Argentinean public hospital

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-01-01 DOI:10.1016/j.ram.2022.05.010

Andrea N. Crivaro , Paula Carasi , Ileana Salto , Ayelen Hugo , P. Cecilia Soldavini Pelichotti , Agustina Bengoa , Melisa Fragomeno , María A. Serradell , Jessica Minnaard , Ivanna Rolny , Eduardo Alul , Leandro Arregui , Macarena E. Fabra Martinez , Oscar Javier Moreno Valero , Andrea Facente , Francisco Magariños , Virginia Jewtuchowicz , Pablo F. Pérez , Fernando M. Trejo

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引用次数: 0

Abstract

Clostridioides difficile is a spore-forming anaerobe microorganism associated to nosocomial diarrhea. Its virulence is mainly associated with TcdA and TcdB toxins, encoded by their respective tcdA and tcdB genes. These genes are part of the pathogenicity locus (PaLoc). Our aim was to characterize relevant C. difficile toxinotypes circulating in the hospital setting. The tcdA and tcdB genes were amplified and digested with different restriction enzymes: EcoRI for tcdA; HincII and AccI for tcdB. In addition, the presence of the cdtB (binary toxin) gene, TcdA and TcdB toxins by dot blot and the cytotoxic effect of culture supernatants on Vero cells, were evaluated. Altogether, these studies revealed three different circulating toxinotypes according to Rupnik's classification: 0, I and VIII, being the latter the most prevalent one. Even though more studies are certainly necessary (e.g. sequencing analysis), it is worth noting that the occurrence of toxinotype I could be related to the introduction of bacteria from different geographical origins.

The multivariate analysis conducted on the laboratory values of individuals infected with the most prevalent toxinotype (VIII) showed that the isolates associated with fatal outcomes (GCD13, GCD14 and GCD22) are located in regions of the biplots related to altered laboratory values at admission.

In other patients, although laboratory values at admission were not correlated, levels of urea, creatinine and white blood cells were positively correlated after the infection was diagnosed.

Our study reveals the circulation of different toxinotypes of C. difficile strains in this public hospital. The variety of toxinotypes can arise from pre-existing microorganisms as well as through the introduction of bacteria from other geographical regions. The existence of microorganisms with different pathogenic potential is relevant for the control, follow-up, and treatment of the infections.

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艰难梭菌:阿根廷一家公立医院循环毒素型的特征

艰难梭菌是一种与医院腹泻相关的形成孢子的厌氧微生物。其毒力主要与TcdA和TcdB毒素有关，由它们各自的TcdA和TcdB基因编码。这些基因是致病基因座（PaLoc）的一部分。我们的目的是描述在医院环境中流行的相关艰难梭菌毒素型。扩增tcdA和tcdB基因并用不同的限制性内切酶消化：tcdA的EcoRI；tcdB的HincII和AccI。此外，通过点杂交评估了cdtB（二元毒素）基因、TcdA和TcdB毒素的存在以及培养上清液对Vero细胞的细胞毒性作用。根据Rupnik的分类，这些研究总共揭示了三种不同的循环毒物类型：0、I和VIII，后者是最普遍的一种。尽管肯定有必要进行更多的研究（例如测序分析），但值得注意的是，I型毒素的出现可能与来自不同地理来源的细菌的引入有关。对感染最常见毒型（VIII）的个体的实验室值进行的多变量分析表明，与致命结果相关的分离株（GCD13、GCD14和GCD22）位于与入院时实验室值改变相关的双地块区域。在其他患者中，尽管入院时的实验室值没有相关性，但在确诊感染后，尿素、肌酐和白细胞水平呈正相关。我们的研究揭示了不同毒性类型的艰难梭菌菌株在这家公立医院的循环情况。毒素类型的多样性可能来自预先存在的微生物，也可能来自其他地理区域的细菌。具有不同致病潜力的微生物的存在与感染的控制、随访和治疗有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.