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dc.creatorRamírez Vargas, Gabriel
dc.creatorQuesada Gómez, Carlos
dc.creatorAcuña Amador, Luis Alberto
dc.creatorLópez Ureña, Diana
dc.creatorMurillo Corrales, Tatiana
dc.creatorGamboa Coronado, María del Mar
dc.creatorChaves Olarte, Esteban
dc.creatorThomson, Nicholas R.
dc.creatorRodríguez Cavallini, Evelyn
dc.creatorRodríguez Sánchez, César
dc.date.accessioned2018-06-06T18:33:12Z
dc.date.available2018-06-06T18:33:12Z
dc.date.issued2017-01
dc.identifier.citationhttp://aac.asm.org/content/61/4/e02054-16#aff-1es_ES
dc.identifier.issn1098-6596
dc.identifier.urihttp://hdl.handle.net/10669/74853
dc.description.abstractThe antimicrobial resistance (AMR) rates and levels recorded for Clostridium difficile are on the rise. This study reports the nature, levels, diversity, and genomic context of the antimicrobial resistance of human C. difficile isolates of the NAPCR1/RT012/ST54 genotype, which caused an outbreak in 2009 and is endemic in Costa Rican hospitals. To this end, we determined the susceptibilities of 38 NAPCR1 isolates to 10 antibiotics from seven classes using Etests or macrodilution tests and examined 31NAPCR1 whole-genome sequences to identify single nucleotide polymorphisms (SNPs) and genes that could explain the resistance phenotypes observed. The NAPCR1 isolates were multidrug resistant (MDR) and commonly exhibited very high resistance levels. By sequencing their genomes, we showed that they possessed resistance-associated SNPs in gyrA and rpoB and carried eight to nine acquired antimicrobial resistance (AMR) genes. Most of these genes were located on known or novel mobile genetic elements shared by isolates recovered at different hospitals and at different time points. Metronidazole and vancomycin remain the first-line treatment options for these isolates. Overall, the NAPCR1 lineage showed an enhanced ability to acquire AMR genes through lateral gene transfer. On the basis of this finding, we recommend further vigilance and the adoption of improved control measures to limit the dissemination of this lineage and the emergence of more C. difficile MDR strains.es_ES
dc.description.sponsorshipMinisterio de Ciencia, Tecnología y Telecomunicaciones de la República/[803-B4-510]MICITT/Costa Ricaes_ES
dc.description.sponsorshipUniversidad de Costa Rica/[803-B4-652]/UCR/Costa Ricaes_ES
dc.description.sponsorshipUniversidad de Costa Rica/[803-B5-600]/UCR/Costa Ricaes_ES
dc.description.sponsorshipUniversidad de Costa Rica/[803-B5-770]/UCR/Costa Ricaes_ES
dc.language.isoen_USes_ES
dc.relation.ispartof
dc.sourceAntimicrobial Agents and Chemotherapy. Vol 61. Núm 4. pp 1-12es_ES
dc.subjectClostridium difficilees_ES
dc.subjectNAPCR1es_ES
dc.subjectMultidrug resistancees_ES
dc.subjectComparative genomicses_ES
dc.subject579.364 Clostridiumes_ES
dc.titleA Clostridium difficile Lineage Endemic to Costa Rican Hospitals Is Multidrug Resistant by Acquisition of Chromosomal Mutations and Novel Mobile Genetic Elementses_ES
dc.typeinfo:eu-repo/semantics/articlees_ES
dc.typeArtículo científicoes_ES
dc.date.updated2018-06-01T18:44:06Z
dc.identifier.doi10.1128/AAC.02054-16
dc.description.procedenceUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Centro de Investigación en Enfermedades Tropicales (CIET)es_ES
dc.identifier.codproyecto803-B4-652
dc.identifier.codproyecto803-B5-600
dc.identifier.codproyecto803-B5-770


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