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Volume 24, Number 4—April 2018
Dispatch

Imipenem Resistance in Clostridium difficile Ribotype 017, Portugal

Joana Isidro, Andrea Santos, Alexandra Nunes, Vítor Borges, Catarina Silva, Luís Vieira, Aristides L. Mendes, Mónica Serrano, Adriano O. Henriques, João Paulo Gomes, and Mónica OleastroComments to Author 
Author affiliations: National Institute of Health, Lisbon, Portugal (J. Isidro, A. Santos, A. Nunes, V. Borges, C. Silva, L. Vieira, J.P. Gomes, M. Oleastro); Instituto de Tecnologia Química e Biológica António Xavier, Oeiras, Portugal (A.L. Mendes, M. Serrano, A.O. Henriques)

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Table 1

Susceptibility of Clostridium difficile RT017 imipenem-resistant isolates from hospital A and imipenem-susceptible isolates from hospital B to 11 antimicrobial drugs, Portugal*

Hospital
 Resistance breakpoint†
 Antimicrobial drug, MIC breakpoints, mg/L
IMP‡ ETP‡ MRP‡ MXF†§ MTZ†§ VAN†§ CLI‡ CHL‡ RIF† TGC† TET‡
>16
 >16
 >16
 >4
 >2
 >2
 >8
 >32
 >0.004
 >0.25
 >16
A, 22 isolates
 MIC range >32 3–16 1.5–4 >32 <0.016–1 0.38–2 >256 2–6 >32 <0.016–0.094 16–32
GM MIC 32 7.56 2.31 32 0.12 0.73 256 3.29 32 0.025 18.08
MIC90 32 12 3 >32 0.38 2 256 4 32 0.032 32
MIC50 32 6 2 >32 0.19 0.75 256 3 32 0.023 16
% Resistant
 100
 4.5
 0
 100
 0
 0
 100
 0
 100
 0
 100
B, 3 isolates
 MIC range 1.5–3 1.5–2 0.5–1.5 1.5 <0.016–0.25 0.38–0.75 >256 3–4 >32 <0.016–0.023 16
GM MIC 2.08 1.82 0.83 1.5 0.072 0.60 256 3.30 32 0.020 16
MIC90 3 2 1.5 1.5 0.25 0.75 256 4 32 0.023 16
MIC50 2 2 0.75 1.5 0.094 0.75 256 3 32 0.023 16
% Resistant
 0
 0
 0
 0
 0
 0
 100
 0
 100
 0
 100
p value <0.0001 <0.0001 <0.0001 <0.0001 0.45 0.56 ND 0.98 ND 0.41 0.51

*CHL, chloramphenicol; CLI, clindamycin; ETP, ertapenem; GM, geometric mean; IMP, imipenem; MIC50, minimal inhibitory concentration for 50% of strains; MIC90, minimal inhibitory concentration for 90% of strains; MRP, meropenem; MTZ, metronidazole; MXF, moxifloxacin; ND, not done; RIF, rifampin; TGC, tigecycline; VAN, vancomycin.
†European Committee on Antimicrobial Susceptibility Testing breakpoint.
‡Clinical and Laboratory Standards Institute breakpoint.
§Previously determined (9).

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Page updated: March 16, 2018
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