Antimicrobial resistance in Clostridium difficile.
Clostridium difficile is the leading cause of hospital-acquired diarrhoea and the number of outbreaks has risen markedly since 2003. The emergence and spread of resistance in C. difficile is complicating treatment and prevention. Most isolates are still susceptible to vancomycin and metronidazole (MTZ), however transient and heteroresistance to MTZ have been reported. The prevalence of resistance to other antimicrobial agents is highly variable in different populations and in different countries, ranging from 0% to 100%. Isolates of common polymerase chain reaction (PCR) ribotypes are more resistant than uncommon ribotypes. Most of the resistance mechanisms that have been identified in C. difficile are similar to those in other Gram-positive bacteria, including mutation, selection and acquisition of the genetic information that encodes resistance. Better antibiotic stewardship and infection control are needed to prevent further spread of resistance in C. difficile.
Huang
Haihui
H
Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China.
Weintraub
Andrej
A
Fang
Hong
H
Nord
Carl Erik
CE
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016360:Clostridioides difficile / Q000187:drug effects* / Q000302:isolation & purification; D003428:Cross Infection / Q000382:microbiology; D003967:Diarrhea / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D008826:Microbial Sensitivity Tests
D000900:Anti-Bacterial Agents