Linda Tkhawkho1, Orna Nitzan2, Nina Pastukh3, Diana Brodsky3, Karen Jackson4, Avi Peretz5. 1. Clinical Microbiology Laboratory, Baruch Padeh Medical Center, Poriya, Israel; Tel Hai College, Kiryat Shmona, Israel. 2. Faculty of Medicine, Bar Ilan University, Galilee, Israel; Unit of Infectious Diseases, Baruch Padeh Medical Center, Poriya, Israel. 3. Clinical Microbiology Laboratory, Baruch Padeh Medical Center, Poriya, Israel. 4. Tel Hai College, Kiryat Shmona, Israel; Migal-Galilee Research Institute, Kiryat Shmona, Israel. 5. Clinical Microbiology Laboratory, Baruch Padeh Medical Center, Poriya, Israel; Faculty of Medicine, Bar Ilan University, Galilee, Israel. Electronic address: aperetz@poria.health.gov.il.
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.
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. difficileinfection. 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: Meng Pu; Janice M Cho; Scott A Cunningham; Gaurav K Behera; Sarah Becker; Talal Amjad; Kerryl E Greenwood-Quaintance; Helena Mendes-Soares; Yava Jones-Hall; Patricio R Jeraldo; Jun Chen; Gary Dunny; Robin Patel; Purna C Kashyap Journal: Gastroenterology Date: 2020-11-14 Impact factor: 22.682