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Isolation and characterization of a multidrug-resistant Clostridioides difficile toxinotype V from municipal wastewater treatment plant

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Abstract

Purpose

Wastewater treatment plant (WWTP) is regarded as a potential source for transmission of Clostridioides difficile from urban areas into the surface water, through feces of human and animals. The aim of this study was to screen and characterize the C. difficile bacteria in inlet and outlet wastewater of different WWTPs in Tehran, Iran.

Methods

Totally, 72 samples were collected from three different WWTPs (inlet site and outlet sites) during a year. C. difficile was isolated and characterized in terms of toxins, toxinotype, resistance profile and genes, and colonization factors using PCR.

Results

One C. difficile toxinotype V was isolated from the outlet samples. The isolate was susceptible to vancomycin but resistant to metronidazole, tetracycline, ciprofloxacin, and moxifloxacin using MIC Test Strips. The isolated C. difficile was toxigenic (tcdA, tcdB, cdtA, cdtB positive and CPE positive) and had tcdC-A genotype. No mutations were found in fliC and fliD. The slpA sequence type was 078 − 01. The C. difficile was positive for tetM, int, but negative for vanA, nim, and tndX genes. Mutations were not observed in gyrA and gyrB genes.

Conclusions

This study provided evidence of presence of a multidrug-resistant C. difficile toxinotype V in one of the municipal WWTP. The transmission of such isolate to the environment and reuse of treated wastewater by human pose a threat to human health and dissemination of antibiotic resistant bacteria which are untreatable.

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Acknowledgements

This research was supported by a grant from Tehran University of Medical Sciences & Health Services (grant number: 30315).

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Authors and Affiliations

  1. Division of Microbiology, Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, PO Box: 14155-6446, Tehran, Iran

    Akram Baghani, Amir Aliramezani & Masoumeh Douraghi

  2. Center for Water Quality Research (CWQR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran

    Mahmood Alimohammadi, Alireza Mesdaghinia & Masoumeh Douraghi

  3. Department of Environmental Health Engineering, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Mahmood Alimohammadi & Alireza Mesdaghinia

  4. Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

    Maliheh Talebi

  5. Center for Water Quality Research (CWQR), Department of Environmental Health Engineering, School of Public Health, Institute for Environmental Research (IER), Tehran University of Medical Sciences, PO Box: 14155-6446, Tehran, Iran

    Alireza Mesdaghinia

  6. Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran

    Masoumeh Douraghi

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  1. Akram Baghani
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Baghani, A., Alimohammadi, M., Aliramezani, A. et al. Isolation and characterization of a multidrug-resistant Clostridioides difficile toxinotype V from municipal wastewater treatment plant. J Environ Health Sci Engineer 18, 1281–1288 (2020). https://doi.org/10.1007/s40201-020-00546-0

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