Distribution of Clostridioides difficile ribotypes isolated from patients in North Macedonia - Update

Abstract

As one of the major hospital pathogens Clostridioides difficile strains are constantly a subject of typing. PCR ribotyping is the standard molecular typing method for this bacteriumin Europe.The aim of this study wasto determine the distribution of C.difficileribotypes isolated from patients in North Macedonia.Eighty isolatesof C.difficile, isolated from the same number of patients`fecalsamples being sent to the Institute of Microbiology and Parasitology in Skopjein the periodfrom 2016to 2020in order to diagnose C.difficileinfection, were included.PCR ribotyping was performed by using primers and protocolsdescribed by Bidet. The final determination of the ribotypes was done by using the software BioNumerics.We determinedthe presence of 20 ribotypes. The most commonribotype was 001/072 represented with 32 (40%) isolates,followed by 014/020 represented with 10 (12,5%) isolates and ribotypes 002, 017 and 027 represented by 5 (6,2%) isolates each. All other ribotypes were represented by less than 4 isolates. Allribotype 001/072isolatesoriginated from patients of the “Mother Teresa”Clinical Center. Unlike in most of the European countries where the hypervirulent ribotype 027 is the dominant one, for a prolonged period of time001/072 has beenthe dominantC. difficileribotype isolated from patients in our country.Considering that most of the isolates of this ribotype hadoriginated from Surgicaland Internal DiseasesClinics in the “Mother Teresa” Clinical Center, we might assume that it is the endemic C. difficile strain there.