ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Reference Susceptibility Testing and Genomic Surveillance of Clostridioides difficile, United States, 2012-17.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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23 citing papers in PubMed, 28 citations in OpenAlex.
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- Pharmacokinetic analysis and steady-state predictions of different preparations of metronidazole administered per rectum in adult horses.Journal of veterinary internal medicine · 2026Article
- A severe Clostridioides difficile ribotype 027 infection in Beijing, China, july 2024.BMC infectious diseases · 2025Article
- Review
- Baicalein and Berberine Inhibit the Growth and Virulence ofPathogens (Basel, Switzerland) · 2025Article
- Minimum Inhibitory Concentration Increase inMicroorganisms · 2025Article
- Emergence and Spread of Clostridioides difficile Isolates With Reduced Fidaxomicin Susceptibility in an Acute Care Hospital.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Community-AcquiredInternational journal of molecular sciences · 2025Review
- Reduced Vancomycin Susceptibility inOpen forum infectious diseases · 2024Article
- Reduced Vancomycin Susceptibility in Clostridioides difficile Is Associated With Lower Rates of Initial Cure and Sustained Clinical Response.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Recent development and fighting strategies for lincosamide antibiotic resistance.Clinical microbiology reviews · 2024Review
- Review
- Genetic determinants of resistance to antimicrobial therapeutics are rare in publicly available Clostridioides difficile genome sequences.The Journal of antimicrobial chemotherapy · 2024Article
- Advances in Therapeutic Strategies for the Management ofJournal of clinical medicine · 2024Review
- Antimicrobial Resistance ofInfection and drug resistance · 2024Article
- Host-defense piscidin peptides as antibiotic adjuvants against Clostridioides difficile.PloS one · 2024Article
- Virulence and genomic diversity among clinical isolates of ST1 (BI/NAP1/027) Clostridioides difficile.Cell reports · 2023Article
- Insights into the Evolving Epidemiology ofAntibiotics (Basel, Switzerland) · 2023Review
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19 authors at 1 institution in 1 country.
Funding
Abstract
backgroundAntimicrobial susceptibility testing (AST) is not routinely performed for Clostridioides difficile and data evaluating minimum inhibitory concentrations (MICs) are limited. We performed AST and whole genome sequencing (WGS) for 593 C. difficile isolates collected between 2012 and 2017 through the Centers for Disease Control and Prevention's Emerging Infections Program.
methodsMICs to 6 antimicrobial agents (ceftriaxone, clindamycin, meropenem, metronidazole, moxifloxacin, and vancomycin) were determined using the reference agar dilution method according to Clinical and Laboratory Standards Institute guidelines. Whole genome sequencing was performed on all isolates to detect the presence of genes or mutations previously associated with resistance.
resultsAmong all isolates, 98.5% displayed a vancomycin MIC ≤2 μg/mL and 97.3% displayed a metronidazole MIC ≤2 μg/mL. Ribotype 027 (RT027) isolates displayed higher vancomycin MICs (MIC50: 2 μg/mL; MIC90: 2 μg/mL) than non-RT027 isolates (MIC50: 0.5 μg/mL; MIC90: 1 μg/mL) (P < .01). No vanA/B genes were detected. RT027 isolates also showed higher MICs to clindamycin and moxifloxacin and were more likely to harbor associated resistance genes or mutations.
conclusionsElevated MICs to antibiotics used for treatment of C. difficile infection were rare, and there was no increase in MICs over time. The lack of vanA/B genes or mutations consistently associated with elevated vancomycin MICs suggests there are multifactorial mechanisms of resistance. Ongoing surveillance of C. difficile using reference AST and WGS to monitor MIC trends and the presence of antibiotic resistance mechanisms is essential.
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