title: Molecular types and antimicrobial susceptibility patterns of Clostridium difficile isolates in different epidemiological settings in a tertiary care center in Israel.
abstract: The aims of this prospective study were to examine the correlation between the molecular types and the antimicrobial susceptibility patterns of Clostridium difficile isolates with the source of acquisition and the occurrence of C. difficile infections (CDI) in a tertiary center in Israel. All available isolates from community-acquired (CA) CDI episodes (n=43) and matching numbers of isolates from community-onset, hospital acquired (CO-HA, n=67) and HA-CDI (n=56) and 32 cases of recurrent CDI were typed and tested for susceptibility to vancomycin and metronidazole. The most common types were SlpA hr-02 (21%), SlpA hr-05/PCR-ribotype-014 (12%), PCR-ribotype-027 (10%) and SlpA cr-02 (10%). The PCR-ribotype-027 was most common in the CO-HA group and the hr-05 type was more common in the CA group. Non-susceptibility to metronidazole and/or vancomycin was found in 4/7 of re-infection isolates. Our study shows that CA-CDI is uncommon and is caused by similar strains as HA-CDI, albeit with different rates.
authors.affiliation: Section of Epidemiology, Tel-Aviv Sourasky Medical Center, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Tamar
authors.initials: T
authors.lastname: Miller-Roll
authors.affiliation: Section of Epidemiology, Tel-Aviv Sourasky Medical Center, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Wasef
authors.initials: W
authors.lastname: Na'amnih
authors.affiliation: School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
authors.forename: Dani
authors.initials: D
authors.lastname: Cohen
authors.affiliation: Section of Epidemiology, Tel-Aviv Sourasky Medical Center, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Carmeli
authors.affiliation: Section of Epidemiology, Tel-Aviv Sourasky Medical Center, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel. Electronic address: amosa@tlvmc.gov.il.
authors.forename: Amos
authors.initials: A
authors.lastname: Adler
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016022:Case-Control Studies; D016360:Clostridioides difficile / Q000145:classification* / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000453:epidemiology / Q000382:microbiology*; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D005838:Genotype; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008795:Metronidazole / Q000494:pharmacology; D011446:Prospective Studies; D062606:Tertiary Care Centers; D014640:Vancomycin / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole; D014640:Vancomycin
keywords: Clostridium difficile; Community-acquired; Typing