1
|
Crivaro AN, Carasi P, Salto I, Hugo A, Soldavini Pelichotti PC, Bengoa A, Fragomeno M, Serradell MA, Minnaard J, Rolny I, Alul E, Arregui L, Fabra Martinez ME, Moreno Valero OJ, Facente A, Magariños F, Jewtuchowicz V, Pérez PF, Trejo FM. Clostridioides difficile: Characterization of the circulating toxinotypes in an Argentinean public hospital. Rev Argent Microbiol 2023; 55:73-82. [PMID: 35840437 DOI: 10.1016/j.ram.2022.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 02/22/2022] [Accepted: 05/02/2022] [Indexed: 02/07/2023] Open
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.
Collapse
Affiliation(s)
- Andrea N Crivaro
- Cátedra de Microbiología, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, Calle 47 y 115, B1900AJI La Plata, Argentina; IIFP, Universidad Nacional de La Plata, CONICET, Facultad de Ciencias Exactas, Departamento de Ciencias Biológicas, La Plata, Argentina
| | - Paula Carasi
- IIFP, Universidad Nacional de La Plata, CONICET, Facultad de Ciencias Exactas, Departamento de Ciencias Biológicas, La Plata, Argentina
| | - Ileana Salto
- Cátedra de Microbiología, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, Calle 47 y 115, B1900AJI La Plata, Argentina; IBBM (Instituto de Biotecnología y Biología Molecular), CCT-CONICET-La Plata, Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, Calles 47 y 115 (1900), La Plata, Argentina
| | - Ayelen Hugo
- Centro de Investigación y Desarrollo en Criotecnología de Alimentos, CCT La Plata, CONICET-UNLP-CIC PBA, 47 y 116 (s/n), La Plata 1900, Argentina
| | - P Cecilia Soldavini Pelichotti
- Cátedra de Microbiología, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, Calle 47 y 115, B1900AJI La Plata, Argentina; Centro de Investigación y Desarrollo en Criotecnología de Alimentos, CCT La Plata, CONICET-UNLP-CIC PBA, 47 y 116 (s/n), La Plata 1900, Argentina
| | - Agustina Bengoa
- Centro de Investigación y Desarrollo en Criotecnología de Alimentos, CCT La Plata, CONICET-UNLP-CIC PBA, 47 y 116 (s/n), La Plata 1900, Argentina
| | - Melisa Fragomeno
- Centro de Investigación y Desarrollo en Criotecnología de Alimentos, CCT La Plata, CONICET-UNLP-CIC PBA, 47 y 116 (s/n), La Plata 1900, Argentina
| | - María A Serradell
- Cátedra de Microbiología, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, Calle 47 y 115, B1900AJI La Plata, Argentina
| | - Jessica Minnaard
- Cátedra de Microbiología, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, Calle 47 y 115, B1900AJI La Plata, Argentina; Centro de Investigación y Desarrollo en Criotecnología de Alimentos, CCT La Plata, CONICET-UNLP-CIC PBA, 47 y 116 (s/n), La Plata 1900, Argentina
| | - Ivanna Rolny
- Cátedra de Microbiología, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, Calle 47 y 115, B1900AJI La Plata, Argentina; IIFP, Universidad Nacional de La Plata, CONICET, Facultad de Ciencias Exactas, Departamento de Ciencias Biológicas, La Plata, Argentina
| | - Eduardo Alul
- Luisa G de Gandulfo Hospital, Lomas de Zamora, Buenos Aires, Argentina
| | - Leandro Arregui
- Luisa G de Gandulfo Hospital, Lomas de Zamora, Buenos Aires, Argentina
| | | | | | - Andrea Facente
- Luisa G de Gandulfo Hospital, Lomas de Zamora, Buenos Aires, Argentina
| | | | | | - Pablo F Pérez
- Cátedra de Microbiología, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, Calle 47 y 115, B1900AJI La Plata, Argentina; Centro de Investigación y Desarrollo en Criotecnología de Alimentos, CCT La Plata, CONICET-UNLP-CIC PBA, 47 y 116 (s/n), La Plata 1900, Argentina.
| | - Fernando M Trejo
- Centro de Investigación y Desarrollo en Criotecnología de Alimentos, CCT La Plata, CONICET-UNLP-CIC PBA, 47 y 116 (s/n), La Plata 1900, Argentina
| |
Collapse
|