Clostridium difficile with Moxifloxacin-Clindamycin Resistance in Vegetables in Ohio, USA, and Prevalence Meta-AnalysisReportar como inadecuado

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Journal of Pathogens - Volume 2014 2014, Article ID 158601, 7 pages -

Research Article

Division of Gastroenterology and Liver Disease, Digestive Research Center, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA

Department of Human Nutrition, College of Human Nutrition and Human Sciences, The Ohio State University, Columbus, OH 43210, USA

Food Animal Health Research Program, Ohio Agricultural Research and Development Center, The Ohio State University, Wooster, OH 44691, USA

Received 9 September 2014; Revised 8 November 2014; Accepted 17 November 2014; Published 14 December 2014

Academic Editor: Nongnuch Vanittanakom

Copyright © 2014 Alex Rodriguez-Palacios et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We i determined the prevalence of Clostridium difficile and their antimicrobial resistance to six antimicrobial classes, in a variety of fresh vegetables sold in retail in Ohio, USA, and ii conducted cumulative meta-analysis of reported prevalence in vegetables since the 1990s. Six antimicrobial classes were tested for their relevance as risk factors for C. difficile infections CDIs clindamycin, moxifloxacin or their clinical priority as exhaustive therapeutic options metronidazole, vancomycin, linezolid, and tigecycline. By using an enrichment protocol we isolated C. difficile from three of 125 vegetable products 2.4%. All isolates were toxigenic, and originated from 4.6% of 65 vegetables cultivated above the ground ; outer leaves of iceberg lettuce, green pepper, and eggplant. Root vegetables yielded no C. difficile. The C. difficile isolates belonged to two PCR ribotypes, one with an unusual antimicrobial resistance for moxifloxacin and clindamycin lettuce and pepper; 027-like, A



; tcdC 18 bp deletion; the other PCR ribotype eggplant, A



; classic tcdC was susceptible to all antimicrobials. Results of the cumulative weighted meta-analysis 6 studies indicate that the prevalence of C. difficile in vegetables is 2.1% and homogeneous since the first report in 1996 2.4%. The present study is the first report of the isolation of C. difficile from retail vegetables in the USA. Of public health relevance, antimicrobial resistance to moxifloxacin-clindamycin a bacterial-associated risk factor for severe CDIs was identified on the surface of vegetables that are consumed raw.

Autor: Alex Rodriguez-Palacios, Sanja Ilic, and Jeffrey T. LeJeune



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