ArticleThe Journal of antimicrobial chemotherapy2021
Haem is crucial for medium-dependent metronidazole resistance in clinical isolates of Clostridioides difficile.
Article in The Journal of antimicrobial chemotherapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 54 citations in OpenAlex.
- Ecological and dietary strategies to constrain Clostridioides difficile.Cell host & microbe · 2026Review
- Clostridioides difficile pathogenesis and control.Nature reviews. Microbiology · 2026Review
- Reversion of heme-dependent metronidazole resistance inMicrobiology spectrum · 2026Article
- Characterization of the clade 4 non-toxigenicFEMS microbes · 2026Article
- Genomic islands and molecular mechanisms relating to drug-resistance inEmerging microbes & infections · 2025Article
- History and Evolution of the HypervirulentMicroorganisms · 2025Review
- DNA-bound structure of Clostridioides difficile heme-sensing HsmR gives insight on how the unique dimer mode governs DNA specificity in MarR transcriptional regulators.Nucleic acids research · 2025Article
- Cost-Effective Nanosensor Solutions for Ultra-Sensitive Detection of Metronidazole.Analytical science advances · 2025Review
- Newly emerging metronidazole-resistantEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Article
- Genetic determinants of resistance to antimicrobial therapeutics are rare in publicly available Clostridioides difficile genome sequences.The Journal of antimicrobial chemotherapy · 2024Article
- Proteomics-Based RT-qPCR and Functional Analysis of 18 Genes in Metronidazole Resistance ofAntibiotics (Basel, Switzerland) · 2024Article
- Review
- Liberation of host heme bymBio · 2024Article
- European Practice for CDI Treatment.Advances in experimental medicine and biology · 2024Article
- Host-defense piscidin peptides as antibiotic adjuvants against Clostridioides difficile.PloS one · 2024Article
- The ESCMID Study Group for Clostridioides difficile: History, Role, and Perspectives.Advances in experimental medicine and biology · 2024Article
- Antibiotic Resistances of Clostridioides difficile.Advances in experimental medicine and biology · 2024Article
- Antimicrobial Resistance ofInfection and drug resistance · 2024Article
- Decoding a cryptic mechanism of metronidazole resistance among globally disseminated fluoroquinolone-resistant Clostridioides difficile.Nature communications · 2023Article
- Surveillance of Clostridioides difficile Antimicrobial Resistance in the United States.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUntil recently, metronidazole was the first-line treatment for Clostridioides difficile infection and it is still commonly used. Though resistance has been reported due to the plasmid pCD-METRO, this does not explain all cases.
objectivesTo identify factors that contribute to plasmid-independent metronidazole resistance of C. difficile.
methodsHere, we investigate resistance to metronidazole in a collection of clinical isolates of C. difficile using a combination of antimicrobial susceptibility testing on different solid agar media and WGS of selected isolates.
resultsWe find that nearly all isolates demonstrate a haem-dependent increase in the MIC of metronidazole, which in some cases leads to isolates qualifying as resistant (MIC >2 mg/L). Moreover, we find an SNP in the haem-responsive gene hsmA, which defines a metronidazole-resistant lineage of PCR ribotype 010/MLST ST15 isolates that also includes pCD-METRO-containing strains.
conclusionsOur data demonstrate that haem is crucial for medium-dependent metronidazole resistance in C. difficile.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.