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J Clin Microbiol. 2017 Jul;55(7):1998-2008. doi: 10.1128/JCM.02250-16. Epub 2017 Apr 12.

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

Author information

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 Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA tangy@mskcc.org sun5@health.usf.edu.
8
Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, New York, USA.
9
Department of Molecular Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA tangy@mskcc.org sun5@health.usf.edu.
10
Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.

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.

KEYWORDS:

Clostridium difficile; antibiotics; biofilm; drug resistance; testing

PMID:
28404671
PMCID:
PMC5483901
DOI:
10.1128/JCM.02250-16
[Indexed for MEDLINE]
Free PMC Article

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