ArticleAntimicrobial agents and chemotherapy2012
Characterizations of clinical isolates of clostridium difficile by toxin genotypes and by susceptibility to 12 antimicrobial agents, including fidaxomicin (OPT-80) and rifaximin: a multicenter study in Taiwan.
Article in Antimicrobial agents and chemotherapy, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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25 citing papers in PubMed, 1 synthesis or guideline pooled it, 57 citations in OpenAlex.
- Antimicrobial resistance in Clostridioides (Clostridium) difficile derived from humans: a systematic review and meta-analysis.Antimicrobial resistance and infection control · 2020Pooled it
- Rifaximin resistance in Clostridioides difficile is associated with specific rpoB alleles and multilocus sequence typing (MLST) clades.BMC microbiology · 2025Article
- The latest research progress on the clinical application of nemonoxacin.Frontiers in medicine · 2025Review
- Defining the phylogenetics and resistome of the majorMicrobial genomics · 2024Article
- Potential effectiveness of parenteral nemonoxacin in the treatment ofFrontiers in microbiology · 2024Article
- Antibiotic Resistances of Clostridioides difficile.Advances in experimental medicine and biology · 2024Article
- Fidaxomicin for the Treatment ofAntibiotics (Basel, Switzerland) · 2022Review
- Antimicrobial resistance in Clostridioides difficile.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2021Review
- Antibiotic Resistances and Molecular Characteristics ofFrontiers in medicine · 2021Article
- Constitutive expression of the cryptic vanGCd operon promotes vancomycin resistance in Clostridioides difficile clinical isolates.The Journal of antimicrobial chemotherapy · 2020Article
- Observational
- Nationwide surveillance of ribotypes and antimicrobial susceptibilities of toxigenicInfection and drug resistance · 2018Article
- Surveillance of antibiotic resistance among common Clostridium difficile ribotypes in Hong Kong.Scientific reports · 2017Article
- A Review of Experimental and Off-Label Therapies for Clostridium difficile Infection.Infectious diseases and therapy · 2017Review
- Antimicrobial susceptibility ofAntimicrobial resistance and infection control · 2017Article
- Recent advances in the understanding of antibiotic resistance in Clostridium difficile infection.Therapeutic advances in infectious disease · 2016Review
- Clostridium difficile in Crete, Greece: epidemiology, microbiology and clinical disease.Epidemiology and infection · 2016Article
- Predominance of Clostridium difficile Ribotypes 017 and 078 among Toxigenic Clinical Isolates in Southern Taiwan.PloS one · 2016Article
- Molecular epidemiology and antimicrobial susceptibility of Clostridium difficile isolated from a university teaching hospital in Japan.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2015Article
- Molecular Epidemiology of Clostridium difficile Infection in a Large Teaching Hospital in Thailand.PloS one · 2015Article
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Authors and funding
4 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A total of 403 nonduplicate isolates of Clostridium difficile were collected at three major teaching hospitals representing northern, central, and southern Taiwan from January 2005 to December 2010. Of these 403 isolates, 170 (42.2%) were presumed to be nontoxigenic due to the absence of genes for toxins A or B or binary toxin. The remaining 233 (57.8%) isolates carried toxin A and B genes, and 39 (16.7%) of these also had binary toxin genes. The MIC(90) of all isolates for fidaxomicin and rifaximin was 0.5 μg/ml (range, ≤ 0.015 to 0.5 μg/ml) and >128 μg/ml (range, ≤ 0.015 to >128 μg/ml), respectively. All isolates were susceptible to metronidazole (MIC(90) of 0.5 μg/ml; range, ≤ 0.03 to 4 μg/ml). Two isolates had reduced susceptibility to vancomycin (MICs, 4 μg/ml). Only 13.6% of isolates were susceptible to clindamycin (MIC of ≤ 2 μg/ml). Nonsusceptibility to moxifloxacin (n = 81, 20.1%) was accompanied by single or multiple mutations in gyrA and gyrB genes in all but eight moxifloxacin-nonsusceptible isolates. Two previously unreported gyrB mutations might independently confer resistance (MIC, 16 μg/ml), Ser416 to Ala and Glu466 to Lys. Moxifloxacin-resistant isolates were cross-resistant to ciprofloxacin and levofloxacin, but some moxifloxacin-nonsusceptible isolates remained susceptible to gemifloxacin or nemonoxacin at 0.5 μg/ml. This study found the diversity of toxigenic and nontoxigenic strains of C. difficile in the health care setting in Taiwan. All isolates tested were susceptible to metronidazole and vancomycin. Fidaxomicin exhibited potent in vitro activity against all isolates tested, while the more than 10% of Taiwanese isolates with rifaximin MICs of ≥ 128 μg/ml raises concerns.
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