Young children are frequently colonized with Clostridioides (C.) difficile. Depending on their resistance patterns, antibiotic treatment can facilitate gastrointestinal spreading in colonized individuals, potentially leading to transmission to others. C. difficile was isolated from stool samples from infants born in two hospitals in Göttingen and Darmstadt, Germany. All isolates were subjected to phenotypic antimicrobial resistance testing, PCR-based screening for toxin genes and mass spectrometry-based exclusion of ribotypes 027 and 176. Within an initial cohort of 324 neonates with a longitudinal survey of C. difficile, 137 strains were isolated from 48 individuals. Antimicrobial resistance was recorded against metronidazole in one (0.7%), erythromycin in 16 (11.7%) and moxifloxacin in 2 (1.5%) of the strains, whereas no resistance was observed against vancomycin (0.0%) or rifampicin (0.0%). Newly observed resistance against erythromycin in children with detection of previously completely sensitive isolates was reported for C. difficile isolates from 2 out of 48 children. In 20 children (42%), non-toxigenic strains were detected, and from 27 children (56%), toxigenic strains were isolated, while both toxigenic and non-toxigenic strains were recorded for 1 child (2%). Ribotypes 027 or 176 were not observed. In conclusion, the German C. difficile strains isolated from the children showed mild to moderate resistance with predominance of macrolide resistance, a substance class which is frequently applied in children. The observed switches to the dominance of macrolide-resistant isolates suggests likely selection of resistant C. difficile strains already in children.

中文翻译：

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从德国新生儿分离的艰难梭菌菌株的抗药性模式。

幼儿经常定植Clostridioides（C.）艰难。根据它们的耐药模式，抗生素治疗可以促进胃肠道在定植的个体中扩散，从而潜在地传播给他人。艰难梭菌是从德国哥廷根和达姆施塔特的两家医院出生的婴儿粪便样本中分离出来的。所有分离物均进行了表型抗药性测试，毒素基因的基于PCR的筛选以及基于核糖核酸的027和176型的质谱排除。在324名新生儿的最初队列中，进行了艰难梭菌的纵向调查。从48个个体中分离出137个菌株。分别对一种菌株的甲硝唑（0.7％），16种红霉素（11.7％）和2种（1.5％）莫西沙星的抗药性有记录，而对万古霉素（0.0％）或利福平（0.0％）的抗药性均未观察到。据报道，从48名儿童中有2名发现艰难梭菌分离物，新发现的儿童对红霉素的耐药性已经检测出以前完全敏感的分离物。在20名儿童（42％）中，检测到非产毒菌株，从27名儿童（56％）中分离出了产毒菌株，而有1名儿童（2％）记录了产毒和非产毒菌株。没有观察到核型027或176。总之，德国艰难梭菌从儿童身上分离出的菌株显示出中等至中等的抵抗力，其中以大环内酯类药物为主，这是一种经常在儿童中使用的物质。观察到的对大环内酯类耐药菌株优势地位的转变表明，可能已经在儿童中选择了耐药艰难梭菌菌株。