ArticlePloS one2013
Characterization of a stable, metronidazole-resistant Clostridium difficile clinical isolate.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers.
What it found
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Who cites it
45 citing papers in PubMed.
- Dietary iron and metal-based growth promoters differentially modulate the gut resistome and Escherichia coli virulome in weaned pigs.Journal of animal science and biotechnology · 2026Article
- Characterization of Adult and Pediatric Healthcare-Associated and Community-Associated Clostridioides difficile Infections, Canada, 2015-2022.Emerging infectious diseases · 2025Article
- Review
- Review
- Microbiome Responses to Oral Fecal Microbiota Transplantation in a Cohort of Domestic Dogs.Veterinary sciences · 2024Article
- Antibiotic Resistances of Clostridioides difficile.Advances in experimental medicine and biology · 2024Article
- Pathogenicity and virulence ofVirulence · 2023Review
- Decoding a cryptic mechanism of metronidazole resistance among globally disseminated fluoroquinolone-resistant Clostridioides difficile.Nature communications · 2023Article
- Antibiotic Resistance in Selected Emerging Bacterial Foodborne Pathogens-An Issue of Concern?Antibiotics (Basel, Switzerland) · 2023Review
- Gut microbiota interspecies interactions shape the response of Clostridioides difficile to clinically relevant antibiotics.PLoS biology · 2023Article
- Non-ToxigenicAntibiotics (Basel, Switzerland) · 2023Article
- Platelets promote human macrophages-mediated macropinocytosis ofFrontiers in cellular and infection microbiology · 2023Article
- Indolin-2-one Nitroimidazole Antibiotics Exhibit an Unexpected Dual Mode of Action.ACS chemical biology · 2022Article
- Characterization of Healthcare-Associated and Community-Associated Clostridioides difficile Infections among Adults, Canada, 2015-2019.Emerging infectious diseases · 2022Article
- Preclinical Data on theAntimicrobial agents and chemotherapy · 2022Article
- Iron Effects onAntibiotics (Basel, Switzerland) · 2022Article
- Rifaximin Therapy for Patients With Metronidazole-Unresponsive Clostridium difficile Infection.Cureus · 2022Article
- Mechanisms and impact of antimicrobial resistance in Clostridioides difficile.Current opinion in microbiology · 2022Review
- Antimicrobial resistance in Clostridioides difficile.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2021Review
- Mechanisms of antibiotic resistance of Clostridioides difficile.The Journal of antimicrobial chemotherapy · 2021Review
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClostridium difficile are gram-positive, spore forming anaerobic bacteria that are the leading cause of healthcare-associated diarrhea, usually associated with antibiotic usage. Metronidazole is currently the first-line treatment for mild to moderate C. difficile diarrhea however recurrence occurs at rates of 15-35%. There are few reports of C. difficile metronidazole resistance in the literature, and when observed, the phenotype has been transient and lost after storage or exposure of the bacteria to freeze/thaw cycles. Owing to the unstable nature of the resistance phenotype in the laboratory, clinical significance and understanding of the resistance mechanisms is lacking. METHODOLOGY/PRINCIPAL
findingsGenotypic and phenotypic characterization was performed on a metronidazole resistant clinical isolate of C. difficile. Whole-genome sequencing was used to identify potential genetic contributions to the phenotypic variation observed with molecular and bacteriological techniques. Phenotypic observations of the metronidazole resistant strain revealed aberrant growth in broth and elongated cell morphology relative to a metronidazole-susceptible, wild type NAP1 strain. Comparative genomic analysis revealed single nucleotide polymorphism (SNP) level variation within genes affecting core metabolic pathways such as electron transport, iron utilization and energy production. CONCLUSIONS/SIGNIFICANCE: This is the first characterization of stable, metronidazole resistance in a C. difficile isolate. The study provides an in-depth genomic and phenotypic analysis of this strain and provides a foundation for future studies to elucidate mechanisms conferring metronidazole resistance in C. difficile that have not been previously described.
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