SynthesisAntimicrobial resistance and infection control2020
Antimicrobial resistance in Clostridioides (Clostridium) difficile derived from humans: a systematic review and meta-analysis.
Synthesis in Antimicrobial resistance and infection control, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 80 papers, 2 of them syntheses that pooled it.
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Who cites it
80 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Antimicrobial resistance inEpidemiology and infection · 2026Pooled it
- Pooled it
- Development a novel in silico mRNA vaccine against Clostridium difficile.Journal, genetic engineering & biotechnology · 2026Article
- Longitudinal surveillance of antibiotic resistance and virulence evolution inMicrobiology spectrum · 2026Article
- Comparison of Phenotypic and Genotypic Antimicrobial Resistances in BovineAntibiotics (Basel, Switzerland) · 2026Article
- Healthcare-associated infections and antimicrobial resistance in Canadian acute care hospitals, 2020-2024.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2026Article
- Antimicrobial Susceptibility ofAntibiotics (Basel, Switzerland) · 2026Article
- Comparative Impacts of Oral Amoxicillin, Azithromycin, and Clindamycin on Gut Microbiota and Intestinal Homeostasis.Antibiotics (Basel, Switzerland) · 2025Article
- Differences in virulence and drug resistance betweenVirulence · 2025Article
- Clostridioides difficile evolution in a tertiary German hospital through a retrospective genomic characterization.Infection · 2025Article
- Effect of preoperative antibiotic use on the implant success rate: a retrospective cohort study of cefixime and ornidazole in China.BMC oral health · 2025Article
- Management ofEClinicalMedicine · 2025Review
- Healthcare-associated infections and antimicrobial resistance in Canadian acute care hospitals, 2019-2023.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2025Article
- Minimum Inhibitory Concentration Increase inMicroorganisms · 2025Article
- Global Burden, Trends, and Inequalities ofAntibiotics (Basel, Switzerland) · 2025Article
- Article
- In vitro susceptibility of clinical Clostridioides difficile isolates in Israel to metronidazole, vancomycin, fidaxomicin, ridinilazole and ibezapolstat.BMC gastroenterology · 2025Article
- Metronidazole and Vancomycin Have a Synergic Effect, with Plant Extracts as Helpful Tools to CombatAntibiotics (Basel, Switzerland) · 2025Article
- Epidemiology and genetic characteristics ofPeerJ · 2025Article
- Characterization of High-Linezolid-MICInfection and drug resistance · 2025Article
20 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClostridioides (Clostridium) difficile is an important pathogen of healthcare- associated diarrhea, however, an increase in the occurrence of C. difficile infection (CDI) outside hospital settings has been reported. The accumulation of antimicrobial resistance in C. difficile can increase the risk of CDI development and/or its spread. The limited number of antimicrobials for the treatment of CDI is matter of some concern.
objectivesIn order to summarize the data on antimicrobial resistance to C. difficile derived from humans, a systematic review and meta-analysis were performed.
methodsWe searched five bibliographic databases: (MEDLINE [PubMed], Scopus, Embase, Cochrane Library and Web of Science) for studies that focused on antimicrobial susceptibility testing in C. difficile and were published between 1992 and 2019. The weighted pooled resistance (WPR) for each antimicrobial agent was calculated using a random- effects model.
resultsA total of 111 studies were included. The WPR for metronidazole and vancomycin was 1.0% (95% CI 0-3%) and 1% (95% CI 0-2%) for the breakpoint > 2 mg/L and 0% (95% CI 0%) for breakpoint ≥32 μg/ml. Rifampin and tigecycline had a WPRs of 37.0% (95% CI 18-58%) and 1% (95% CI 0-3%), respectively. The WPRs for the other antimicrobials were as follows: ciprofloxacin 95% (95% CI 85-100%), moxifloxacin 32% (95% CI 25-40%), clindamycin 59% (95% CI 53-65%), amoxicillin/clavulanate 0% (0-0%), piperacillin/tazobactam 0% (0-0%) and ceftriaxone 47% (95% CI 29-65%). Tetracycline had a WPR 20% (95% CI 14-27%) and meropenem showed 0% (95% CI 0-1%); resistance to fidaxomicin was reported in one isolate (0.08%).
conclusionResistance to metronidazole, vancomycin, fidaxomicin, meropenem and piperacillin/tazobactam is reported rarely. From the alternative CDI drug treatments, tigecycline had a lower resistance rate than rifampin. The high-risk antimicrobials for CDI development showed a high level of resistance, the highest was seen in the second generation of fluoroquinolones and clindamycin; amoxicillin/clavulanate showed almost no resistance. Tetracycline resistance was present in one fifth of human clinical C. difficile isolates.
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