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Antimicrobial Agents and Chemotherapy, June 2002, p. 1647-1650, Vol. 46, No. 6
0066-4804/02/$04.00+0     DOI: 10.1128/AAC.46.6.1647-1650.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Reassessment of Clostridium difficile Susceptibility to Metronidazole and Vancomycin

T. Peláez, L. Alcalá, R. Alonso,* M. Rodríguez-Créixems, J. M. García-Lechuz, and E. Bouza

Microbiology and Infectious Diseases Service, Hospital General Universitario "Gregorio Marañón," Madrid, Spain

Received 10 August 2001/ Returned for modification 1 November 2001/ Accepted 19 February 2002

Clostridium difficile is the most frequently identified enteric pathogen in patients with nosocomially acquired, antibiotic-associated diarrhea. The drugs most commonly used to treat diseases associated with C. difficile are metronidazole and vancomycin. Most clinical laboratories assume that all C. difficile isolates are susceptible to metronidazole and vancomycin. We report on the antimicrobial susceptibilities of 415 C. difficile isolates to metronidazole and vancomycin over an 8-year period (1993 to 2000). The overall rate of resistance to metronidazole at the critical breakpoint (16 µg/ml) was 6.3%. Although full resistance to vancomycin was not observed, the overall rate of intermediate resistance was 3.1%. One isolate had a combination of resistance to metronidazole and intermediate resistance to vancomycin. Rates of resistance to metronidazole and vancomycin were higher among isolates from human immunodeficiency virus-infected patients. Molecular typing methods proved the absence of clonality among the isolates with decreased susceptibilities to the antimicrobials tested.

* Corresponding author. Mailing address: Servicio de Microbiologia Clínica y Enfermedades Infecciosas, Hospital General Universitario "Gregorio Marañon," C/Dr. Esquerdo, 46, 28007, Madrid, Spain. Phone: 34-91-5868793. Fax: 34-91-504 49 06. E-mail: ebouza{at}microb.net.

Antimicrobial Agents and Chemotherapy, June 2002, p. 1647-1650, Vol. 46, No. 6
0066-4804/02/$04.00+0     DOI: 10.1128/AAC.46.6.1647-1650.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



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