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Antimicrobial susceptibility of Clostridium difficile isolates in Israel.
J Glob Antimicrob Resist. 2017 09; 10:161-164.JG

Abstract

OBJECTIVES

An increase of Clostridium difficile isolates with reduced susceptibility to various antimicrobial agents has been observed, including isolates that are non-susceptible to antibiotics that are routinely used for treatment of C. difficile, such as vancomycin and metronidazole. We determined the susceptibility rates of C. difficile isolates from hospitals in northern Israel to various antibiotics including tigecycline, which was not previously reported from Israel.

METHODS

A total of 81 stool samples were collected from three hospitals in northern Israel from patients with C. difficile infection. Specimens were screened for BI/NAP1/027 ribotype, cultured, and sensitivity tests were performed for vancomycin, metronidazole, moxifloxacin, and tigecycline. Statistical tests were applied for analysing the differences in distribution of resistance between the different antibiotics and between BI/NAP1/027 and resistance of antibiotics.

RESULTS

Reduced susceptibility was found among 6/81 isolates for vancomycin, 4/81 for metronidazole, and 17/81 for moxifloxacin. Only 1 isolate had reduced susceptibility to tigecycline, with a mean MIC of 0.05μg/mL. Reduced susceptibility to moxifloxacin was significantly associated with reduced susceptibility to vancomycin (p=0.016) and to metronidazole (p=0.0276), and reduced susceptibility to metronidazole was associated with reduced susceptibility to vancomycin (p=0.0259). Eight of 81 isolates (9.9%) were positive for BI/NAP1/027 ribotype and had significantly higher non-susceptibility rates to moxifloxacin and vancomycin compared with BI/NAP1/027 negative isolates (p<0.0001 and p=0.0113, respectively).

CONCLUSIONS

We found higher non-susceptibility rates to vancomycin and metronidazole than most previous studies, while tigecycline resistance rates are very low in northern Israel, rendering it a potential agent for treating CDI.

Authors+Show Affiliations

Clinical Microbiology Laboratory, Baruch Padeh Medical Center, Poriya, Israel; Tel Hai College, Kiryat Shmona, Israel.Faculty of Medicine, Bar Ilan University, Galilee, Israel; Unit of Infectious Diseases, Baruch Padeh Medical Center, Poriya, Israel.Clinical Microbiology Laboratory, Baruch Padeh Medical Center, Poriya, Israel.Clinical Microbiology Laboratory, Baruch Padeh Medical Center, Poriya, Israel.Tel Hai College, Kiryat Shmona, Israel; Migal-Galilee Research Institute, Kiryat Shmona, Israel.Clinical Microbiology Laboratory, Baruch Padeh Medical Center, Poriya, Israel; Faculty of Medicine, Bar Ilan University, Galilee, Israel. Electronic address: aperetz@poria.health.gov.il.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28729205

Citation

Tkhawkho, Linda, et al. "Antimicrobial Susceptibility of Clostridium Difficile Isolates in Israel." Journal of Global Antimicrobial Resistance, vol. 10, 2017, pp. 161-164.
Tkhawkho L, Nitzan O, Pastukh N, et al. Antimicrobial susceptibility of Clostridium difficile isolates in Israel. J Glob Antimicrob Resist. 2017;10:161-164.
Tkhawkho, L., Nitzan, O., Pastukh, N., Brodsky, D., Jackson, K., & Peretz, A. (2017). Antimicrobial susceptibility of Clostridium difficile isolates in Israel. Journal of Global Antimicrobial Resistance, 10, 161-164. https://doi.org/10.1016/j.jgar.2017.04.005
Tkhawkho L, et al. Antimicrobial Susceptibility of Clostridium Difficile Isolates in Israel. J Glob Antimicrob Resist. 2017;10:161-164. PubMed PMID: 28729205.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antimicrobial susceptibility of Clostridium difficile isolates in Israel. AU - Tkhawkho,Linda, AU - Nitzan,Orna, AU - Pastukh,Nina, AU - Brodsky,Diana, AU - Jackson,Karen, AU - Peretz,Avi, Y1 - 2017/07/17/ PY - 2016/12/19/received PY - 2017/04/03/revised PY - 2017/04/04/accepted PY - 2017/7/22/pubmed PY - 2019/5/14/medline PY - 2017/7/22/entrez KW - BI/NAP1/027 KW - Clostridium difficile KW - Culture KW - Metronidazole KW - Moxifloxacin KW - Tigecycline KW - Vancomycin SP - 161 EP - 164 JF - Journal of global antimicrobial resistance JO - J Glob Antimicrob Resist VL - 10 N2 - OBJECTIVES: An increase of Clostridium difficile isolates with reduced susceptibility to various antimicrobial agents has been observed, including isolates that are non-susceptible to antibiotics that are routinely used for treatment of C. difficile, such as vancomycin and metronidazole. We determined the susceptibility rates of C. difficile isolates from hospitals in northern Israel to various antibiotics including tigecycline, which was not previously reported from Israel. METHODS: A total of 81 stool samples were collected from three hospitals in northern Israel from patients with C. difficile infection. Specimens were screened for BI/NAP1/027 ribotype, cultured, and sensitivity tests were performed for vancomycin, metronidazole, moxifloxacin, and tigecycline. Statistical tests were applied for analysing the differences in distribution of resistance between the different antibiotics and between BI/NAP1/027 and resistance of antibiotics. RESULTS: Reduced susceptibility was found among 6/81 isolates for vancomycin, 4/81 for metronidazole, and 17/81 for moxifloxacin. Only 1 isolate had reduced susceptibility to tigecycline, with a mean MIC of 0.05μg/mL. Reduced susceptibility to moxifloxacin was significantly associated with reduced susceptibility to vancomycin (p=0.016) and to metronidazole (p=0.0276), and reduced susceptibility to metronidazole was associated with reduced susceptibility to vancomycin (p=0.0259). Eight of 81 isolates (9.9%) were positive for BI/NAP1/027 ribotype and had significantly higher non-susceptibility rates to moxifloxacin and vancomycin compared with BI/NAP1/027 negative isolates (p<0.0001 and p=0.0113, respectively). CONCLUSIONS: We found higher non-susceptibility rates to vancomycin and metronidazole than most previous studies, while tigecycline resistance rates are very low in northern Israel, rendering it a potential agent for treating CDI. SN - 2213-7173 UR - https://www.unboundmedicine.com/medline/citation/28729205/Antimicrobial_susceptibility_of_Clostridium_difficile_isolates_in_Israel_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2213-7165(17)30086-3 DB - PRIME DP - Unbound Medicine ER -