Schwartz Orna, Azrad Maya, Peretz Avi
Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.
Clinical Microbiology Laboratory, The Edith Wolfson Medical Center, Holon, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
BMC Gastroenterol. 2025 Mar 31;25(1):209. doi: 10.1186/s12876-025-03800-7.
Antibiotics are currently the primary treatment of Clostridioides difficile (C. difficile) infection. Yet, due to rapid development of resistance and high recurrences rates, there is an unmet need for new antimicrobials for C. difficile infections. This study assessed the in vitro susceptibility of clinical isolates from Israel to two recently developed antibiotics, ridinilazole (RDZ) and ibezapolstat (IBZ), and to standard-of-care antibiotics.
C. difficile isolates (n = 313) recovered from patients at both community and hospital medical centers across Israel, were typed to different sequence types (ST) by multi-locus sequencing typing (MLST). Susceptibility to metronidazole (MTZ) and vancomycin (VAN) was determined using the gradient strip test (Etest). Susceptibility to fidaxomicin (FDX), RDZ and IBZ was determined by agar dilution.
ST42 (39; 12.5%) and ST2 (36; 11.5%) were the most prevalent STs. Resistance to MTZ and VAN was low (2.2%, 1.6%, respectively), while 23 (7.35%) isolates were FDX-resistant. RDZ MIC ranged between 0.06 and 0.5 mg/L, and MIC was 0.25/0.5 mg/L. IBZ had an MIC of 4 mg/L. No significant differences were noted in IBZ MIC of different strains.
RDZ and IBZ demonstrated potent in vitro activity against 313 C. difficile isolates belonging to different STs. These two antimicrobials may serve as effective agents for C. difficile infection.
抗生素是目前治疗艰难梭菌感染的主要方法。然而，由于耐药性的快速发展和高复发率，对治疗艰难梭菌感染的新型抗菌药物仍有未满足的需求。本研究评估了来自以色列的临床分离株对两种最近开发的抗生素瑞地那唑（RDZ）和依贝唑他（IBZ）以及标准护理抗生素的体外敏感性。
从以色列各地社区和医院医疗中心的患者中分离出艰难梭菌菌株（n = 313），通过多位点测序分型（MLST）将其分型为不同的序列类型（ST）。使用梯度纸条试验（Etest）测定对甲硝唑（MTZ）和万古霉素（VAN）的敏感性。通过琼脂稀释法测定对非达霉素（FDX）、RDZ和IBZ的敏感性。
ST42（39株；12.5%）和ST2（36株；11.5%）是最常见的STs。对MTZ和VAN的耐药率较低（分别为2.2%和1.6%），而23株（7.35%）分离株对FDX耐药。RDZ的MIC范围在0.06至0.5 mg/L之间，MIC为0.25/0.5 mg/L。IBZ的MIC为4 mg/L。不同菌株的IBZ MIC未观察到显著差异。
RDZ和IBZ对313株属于不同STs的艰难梭菌分离株显示出强大的体外活性。这两种抗菌药物可能是治疗艰难梭菌感染的有效药物。
