Update on Antimicrobial Resistance in Clostridium difficile: Resistance Mechanisms and Antimicrobial Susceptibility Testing

Author:

Peng Zhong12,Jin Dazhi34ORCID,Kim Hyeun Bum5,Stratton Charles W.6,Wu Bin2,Tang Yi-Wei47ORCID,Sun Xingmin18

Affiliation:

1. Department of Molecular Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA

2. State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, Hubei, China

3. Department of Microbiology, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China

4. Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA

5. Department of Animal Resources Science, Dankook University, Cheonan, South Korea

6. Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA

7. Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, New York, USA

8. Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA

Abstract

ABSTRACT Oral antibiotics such as metronidazole, vancomycin and fidaxomicin are therapies of choice for Clostridium difficile infection. Several important mechanisms for C. difficile antibiotic resistance have been described, including the acquisition of antibiotic resistance genes via the transfer of mobile genetic elements, selective pressure in vivo resulting in gene mutations, altered expression of redox-active proteins, iron metabolism, and DNA repair, as well as via biofilm formation. This update summarizes new information published since 2010 on phenotypic and genotypic resistance mechanisms in C. difficile and addresses susceptibility test methods and other strategies to counter antibiotic resistance of C. difficile .

Funder

HHS | National Institutes of Health

Publisher

American Society for Microbiology

Subject

Microbiology (medical)

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