Antimicrobial resistance in clinical isolates of Clostridioides difficile derived from hospitalised patients in the Czech Republic and Slovakia.

Clostridioides difficile is one of the most common pathogens of healthcare-associated colitis (CDI). However, in recent years there has been an increasing number of reported cases in the community. Causative strain characterization allows us to track the occurrence and spread of certain C. difficile types. To update the current CDI epidemiological situation, between October and November 2021, 342 C. difficile isolates or stool samples from CDI patients for culture were sent from 23 Czech (n=200) and 17 Slovak (n=142) hospitals. All C. difficile isolates were characterized by ribotyping and toxin genes detection. From 342 isolates, 52 different ribotyping profiles were identified. The frequent ribotypes detected were 001, 176, 014, 018 and 020. Genes for toxins A and B were found in all isolates. Genes for binary toxins were detected in 43 (21,5 %) Czech isolates and in 117 (82,4 %) Slovak isolates. Further, selected isolates (n=140, 40,9 %) were subjected to whole-genome sequencing (WGS) and antimicrobial susceptibility testing to 17 antibiotics (E-test). Multilocus sequencing typing determined 30 different sequence types from the 39 included ribotypes. All C. difficile isolates were susceptible to vancomycin, tetracycline, amoxicillin, and meropenem. The most frequently detected antimicrobial..