{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:53:30Z","timestamp":1787320410289,"version":"build-2736575974"},"reference-count":29,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T00:00:00Z","timestamp":1605830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>We aimed to characterize Clostridioides difficile isolates cultured during a six-month single-center study from stool samples of patients with C. difficile infection (CDI) genotyped by the Xpert\u00aeC. difficile\/Epi assay by polymerase chain reaction (PCR) ribotyping, toxin genes\u2019 detection and multi-locus variable number tandem repeats analysis (MLVA). The susceptibility to metronidazole, vancomycin and moxifloxacin was determined by agar dilution. In addition, the presence of Thr82Ile in the GyrA and a single nucleotide deletion at position (\u0394117) in the tcdC gene were investigated. Between January 1 and June 30, 2016, of 114 CDIs, 75 cases were genotyped as presumptive PCR ribotype (RT) 027 infections using a commercial assay. C. difficile isolates cultured from presumptive RT027 stool samples belonged to RT176. These isolates carried genes for toxin A (tcdA), B (tcdB), binary (cdtA\/B) and had \u0394117 in the tcdC gene. Using MLVA, the 71\/75 isolates clustered into two clonal complexes (CCs). Of these, 39 isolates (54.9%) were from patients hospitalized in acute care and 32 isolates (45.1%) were isolated from patients hospitalized in the long-term care department. All isolates were susceptible to metronidazole and vancomycin, and 105 isolates were resistant to moxifloxacin (92%) carrying Thr83Ile in the GyrA. An outbreak of RT176 CDIs, suspected as RT027, was recognized in a Slovakian hospital. In order to monitor the emergence and spread of RT027-variants, the identification of a presumptive RT027 CDI should be confirmed at a strain level by PCR ribotyping.<\/jats:p>","DOI":"10.3390\/jcm9113738","type":"journal-article","created":{"date-parts":[[2020,11,23]],"date-time":"2020-11-23T11:50:34Z","timestamp":1606132234000},"page":"3738","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["An Outbreak of Clostridium (Clostridioides) difficile Infections within an Acute and Long-Term Care Wards Due to Moxifloxacin-Resistant PCR Ribotype 176 Genotyped as PCR Ribotype 027 by a Commercial Assay"],"prefix":"10.3390","volume":"9","author":[{"given":"Elena","family":"Novakova","sequence":"first","affiliation":[{"name":"Department of Microbiology and Immunology, Comenius University Jessenius Faculty of Medicine, 036 01 Martin, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1563-7437","authenticated-orcid":false,"given":"Nina","family":"Kotlebova","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Comenius University Jessenius Faculty of Medicine, 036 01 Martin, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anezka","family":"Gryndlerova","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, 150 06 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Novak","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Comenius University Jessenius Faculty of Medicine, 036 01 Martin, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michala","family":"Vladarova","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Clinical Biochemistry Inc., 012 07 Zilina, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Wilcox","sequence":"additional","affiliation":[{"name":"Healthcare Associated Infection Research Group, Leeds Teaching Hospitals NHS Trust &amp; University of Leeds, Leeds LS2 9JT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ed","family":"Kuijper","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Leiden University Medical Centre, 2300 Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcela","family":"Krutova","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, 150 06 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.anaerobe.2016.06.008","article-title":"Reclassification of Clostridium difficile as Clostridioides difficile (Hall and O\u2019Toole 1935) Pr\u00e9vot 1938","volume":"40","author":"Lawson","year":"2016","journal-title":"Anaerobe"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Cassini, A., Plachouras, D., Eckmanns, T., Abu Sin, M., Blank, H.-P., Ducomble, T., Haller, S., Harder, T., Klingeberg, A., and Sixtensson, M. 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