Two hundred and fifty-three non-duplicate toxigenic Clostridium difficile isolates, collected from February 2012 to December 2014, were evaluated for phenotypic resistance to ten antimicrobial drugs with the E-test gradient diffusion method. All strains of C. difficile were susceptible to metronidazole, vancomycin, and tigecycline. The metronidazole MIC values of the hyperepidemic PCR-ribotypes RT027 and RT176 were higher than those of non-epidemic PCR-ribotypes (p < 0.05, as evidenced by Mann-Whitney U test). In contrast, vancomycin susceptibility did not differ between hyperepidemic and non-epidemic strains, although the difference was almost significant (p = 0.065). Clostridium difficile RT027 and RT176 isolates could be assessed to five and four different susceptibility patterns, respectively, representing various combinations of resistance to different antimicrobial classes. A single point mutation (Thr82Ile) in the gyrA gene was detected in 11 (78.6%) of 14 isolates with high level of resistance to ciprofloxacin and moxifloxacin and four different types of single point mutations (Arg447Lys, Ser416Ala, Asp426Val, Asp426Asn) in the gyrB gene were detected in 4 strains, also with high level of resistance to ciprofloxacin and moxifloxacin. Four different point mutations were detected in the rpoB gene in 21 rifampicin-resistant strains of which one has not been reported previously, Gln489Leu. This study demonstrates the presence of multidrug-resistant C. difficile strains in Polish hospitals over the study period, irrespective of geographical location or reference level of the hospital.

2012年2月至2014年12月收集的253株非重复的产毒性艰难梭菌菌株，通过E检验梯度扩散法评估了对10种抗菌药物的表型耐药性。所有艰难梭菌菌株均对甲硝唑，万古霉素和替加环素敏感。高流行性PCR核糖核酸RT027和RT176的甲硝唑MIC值高于非流行性PCR核糖核酸（p <0.05，Mann-Whitney U检验证明）。相反，高流行和非流行菌株之间万古霉素的敏感性没有差异，尽管差异几乎是显着的（p = 0.065）。艰难梭菌RT027和RT176分离株可分别评估为五种和四种不同的药敏模式，分别代表对不同抗菌剂的抗药性的各种组合。在14株对环丙沙星和莫西沙星具有高水平抗药性的菌株中，有11种（78.6％）检出了gyrA基因中的单点突变（Thr82Ile），并且在该菌株中发现了四种不同类型的单点突变（Arg447Lys，Ser416Ala，Asp426Val，Asp426Asn）。在4个菌株中检测到gyrB基因，它们对环丙沙星和莫西沙星也具有高水平的抗性。在rpoB中检测到四个不同的点突变21个耐利福平菌株中的Gln489Leu基因已经被报道。这项研究表明，在研究期内，波兰医院中存在耐多药艰难梭菌菌株，而与医院的地理位置或参考水平无关。