ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2024
Reduced Vancomycin Susceptibility in Clostridioides difficile Is Associated With Lower Rates of Initial Cure and Sustained Clinical Response.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 29 citations in OpenAlex.
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- Article
- Experimental glycopeptide antibiotic EVG7 prevents recurrent Clostridioides difficile infection by sparing members of the Lachnospiraceae family.Nature communications · 2025Article
- The role of the enteric nervous system in the pathogenesis of Clostridioides difficile infection.Nature reviews. Gastroenterology & hepatology · 2025Review
- 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
- Washed microbiota transplantation for ribotype 027Journal of biomedical research · 2025Article
- Potent Antimicrobial Activity ofAntibiotics (Basel, Switzerland) · 2025Article
- Bioinformatic and experimental identification and characterization ofFrontiers in immunology · 2025Article
- Use of primary oral vancomycin prophylaxis to stem an outbreak ofAntimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Reduced Vancomycin Susceptibility inOpen forum infectious diseases · 2024Article
- Therapeutics involved in managing initial and recurrentWorld journal of gastrointestinal pharmacology and therapeutics · 2024Review
- Bezlotoxumab for prevention ofAnnals of gastroenterologyReview
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundEpidemiologic studies have shown decreasing vancomycin susceptibility among clinical Clostridioides difficile isolates, but the impact on patient outcomes is unknown. We hypothesized that reduced vancomycin susceptibility would be associated with decreased rates of sustained clinical response (SCR).
methodsThis multicenter cohort study included adults with C. difficile infection (CDI) treated with oral vancomycin between 2016 and 2021. Clostridioides difficile isolates underwent agar dilution vancomycin susceptibility testing, ribotyping, and Sanger sequencing of the vancomycin resistance vanR gene. Reduced susceptibility was defined as vancomycin minimum inhibitory concentration (MIC) >2 μg/mL. The primary outcome was 30-day SCR; secondary outcomes were 14-day initial cure, 30-day recurrence, and 30-day mortality. Exploratory analysis assessed the association between the VanR Thr115Ala polymorphism, susceptibility, and outcomes.
resultsA high proportion (34% [102/300]) of C. difficile isolates exhibited reduced vancomycin susceptibility (range, 0.5-16 μg/mL; MIC50/90 = 2/4 μg/mL). Ribotype 027 accounted for the highest proportion (77.4% [41/53]) of isolates with reduced vancomycin susceptibility. Overall, 83% (249) of patients achieved 30-day SCR. Reduced vancomycin susceptibility was associated with lower rates of 30-day SCR (76% [78/102]) than vancomycin-susceptible strains (86% [171/198]; P = .031). A significantly lower rate of 14-day initial cure was also observed among individuals infected with strains with reduced vancomycin susceptibility (89% vs 96%; P = .04). Reduced susceptibility remained an independent predictor of 30-day SCR in multivariable modeling (odds ratio, 0.52 [95% confidence interval, .28-.97]; P = .04).
conclusionsReduced vancomycin susceptibility in C. difficile was associated with decreased odds of 30-day SCR and lower 14-day initial cure rates in the studied patient cohort.
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