ArticleNature communications2023
Decoding a cryptic mechanism of metronidazole resistance among globally disseminated fluoroquinolone-resistant Clostridioides difficile.
Article in Nature communications, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.
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Who cites it
41 citing papers in PubMed, 54 citations in OpenAlex.
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- Comparative genomic analysis of Clostridioides difficile strains in Mexico: insights into virulence and resistance.Access microbiology · 2026Article
- A severe Clostridioides difficile ribotype 027 infection in Beijing, China, july 2024.BMC infectious diseases · 2025Article
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- Faecal pharmacokinetics, microbiome, and bile acid changes in healthy subjects given intravenous followed by oral omadacycline; a Phase 1 clinical trial.The Journal of antimicrobial chemotherapy · 2025Article
- Phenotypic and genotypic antimicrobial resistance profiles of clinical Clostridioides difficile isolates collected from private and public health settings in South Africa.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Article
- Combination of mitomycin C and low-dose metronidazole synergistically againstAntimicrobial agents and chemotherapy · 2025Article
- Survival and Morphological Changes ofMicroorganisms · 2025Article
Corrections and comments
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Authors and funding
14 authors at 6 institutions in 3 countries.
Funding
Abstract
Severe outbreaks and deaths have been linked to the emergence and global spread of fluoroquinolone-resistant Clostridioides difficile over the past two decades. At the same time, metronidazole, a nitro-containing antibiotic, has shown decreasing clinical efficacy in treating C. difficile infection (CDI). Most metronidazole-resistant C. difficile exhibit an unusual resistance phenotype that can only be detected in susceptibility tests using molecularly intact heme. Here, we describe the mechanism underlying this trait. We find that most metronidazole-resistant C. difficile strains carry a T-to-G mutation (which we term PnimB
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