A national survey of the molecular epidemiology of Clostridium difficile in Israel: The dissemination of the ribotype 027 strain with reduced susceptibility to vancomycin and metronidazole

Amos Adler*, Tamar Miller-Roll, Rita Bradenstein, Colin Block, Bracha Mendelson, Miriam Parizade, Yossi Paitan, David Schwartz, Nehama Peled, Yehuda Carmeli, Mitchell J. Schwaber

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

72 Scopus citations

Abstract

Our goals were to study the molecular epidemiology and antimicrobial susceptibilities of C. difficile strains in Israel. Microbiology laboratories serving 6 general hospitals (GH) and 10 long-term care facilities (LTCF) were asked to submit all stool samples in January-February 2014 that tested positive for C. difficile. Toxigenic C. difficile isolates were recovered in 208 out of 217 samples (95.8%), of which 50 (23.6%) were from LTCFs. Ribotype 027 was the most common type overall, identified in 65 samples (31.8%), and was the predominant strain in the 3 GHs with the highest incidence of C. difficile infections. Other common strains were slpA types cr-02 (n. =. 45) and hr-02 (n. =. 18). The proportions of vancomycin and metronidazole MIC values >2. mg/L were high in ribotype 027 (87.7% and 44.6%, respectively) and slpA-cr-02 strains (88.8% and 17.8%, respectively). This study demonstrates that the ribotype 027 strain has disseminated across Israel and is now the most common strain.

Original languageEnglish
Pages (from-to)21-24
Number of pages4
JournalDiagnostic Microbiology and Infectious Disease
Volume83
Issue number1
DOIs
StatePublished - 1 Sep 2015
Externally publishedYes

Keywords

  • Clostridium difficile
  • Epidemic clone
  • Metronidazole
  • Vancomycin

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