TABLE 3

Mechanisms and molecular context of the antibiotic resistance of Clostridium difficile NAPCR1 isolates from Costa Rican hospitals

SmaI pattern(s) (isolate)Resistance-associated SNPaAcquired resistance gene(s)Molecular context of acquired resistance
442, 448, 449, 452, 447,b 488, 558, 578gyrA (Thr82Ile) rpoB (His502Asn Arg505Lys)tetMTn5397
ermBTn5398 variant
aacA-aphDTn4001 inserted into putative mobTn
catDTn4453a inserted into CD630-CTn2 and CD630-CTn5
ant6sat4aphA-3cfr-like genePutative Tn916-like CTn-Ac
489gyrA (Thr82Ile) rpoB (His502Asn Arg505Lys)ermBTn5398 variant
aacA-aphDTn4001 inserted into putative mobTn
catDTn4453a inserted into CD630-CTn2 and CD630-CTn5
ant6sat4aphA-3cfr-like genePutative Tn916-like CTn-Ac
487gyrA (Thr82Ile) rpoB (His502Asn Arg505Lys)tetMTn5397
ermBTn5398 variant
catDTn4453a inserted into CD630-CTn2 and CD630-CTn5
Putative bifunctional aac-aphPhage-like element
ant6sat4aphA-3cfr-like genePutative Tn916-like CTn-Bc
447 (LIBA-5701)gyrA (Thr82Ile) rpoB (His502Asn Arg505Lys)tetMTn5397
ermBTn5398 variant
aacA-aphDTn4001 inserted into putative mobTn
catDTn4453a inserted into CD630-CTn2 and CD630-CTn5
ant6sat4aphA-3Putative Tn916-like CTn-Cc
  • a The MDR strain C. difficile 630 was used as a reference.

  • b Data shown for SmaI pattern 447 here apply to all isolates with this pattern except isolate LIBA-5701.

  • c Three variants of a putative Tn916-like CTn carrying the ant6sat4aphA-3 cluster (designated CTn-A, CTn-B, and CTn-C) were seen among the NAPCR1 strains.