title: Update on Antimicrobial Resistance in Clostridium difficile: Resistance Mechanisms and Antimicrobial Susceptibility Testing.
abstract: Oral antibiotics such as metronidazole, vancomycin and fidaxomicin are therapies of choice forClostridium difficileinfection. Several important mechanisms forC. difficileantibiotic resistance have been described, including the acquisition of antibiotic resistance genes via the transfer of mobile genetic elements, selective pressurein vivoresulting in gene mutations, altered expression of redox-active proteins, iron metabolism, and DNA repair, as well as via biofilm formation. This update summarizes new information published since 2010 on phenotypic and genotypic resistance mechanisms inC. difficileand addresses susceptibility test methods and other strategies to counter antibiotic resistance ofC. difficile.
authors.affiliation: Department of Molecular Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.|State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, Hubei, China.
authors.forename: Zhong
authors.initials: Z
authors.lastname: Peng
authors.affiliation: Department of Microbiology, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China.|Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors.forename: Dazhi
authors.identifier: 0000-0001-7738-1778
authors.initials: D
authors.lastname: Jin
authors.affiliation: Department of Animal Resources Science, Dankook University, Cheonan, South Korea.
authors.forename: Hyeun Bum
authors.initials: HB
authors.lastname: Kim
authors.affiliation: Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: Charles W
authors.initials: CW
authors.lastname: Stratton
authors.affiliation: State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, Hubei, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Wu
authors.affiliation: Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA tangy@mskcc.org sun5@health.usf.edu.|Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, New York, USA.
authors.forename: Yi-Wei
authors.identifier: 0000-0003-4888-6771
authors.initials: YW
authors.lastname: Tang
authors.affiliation: Department of Molecular Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA tangy@mskcc.org sun5@health.usf.edu.|Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
authors.forename: Xingmin
authors.initials: X
authors.lastname: Sun
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016360:Clostridioides difficile / Q000187:drug effects* / Q000235:genetics; D024881:Drug Resistance, Bacterial; D005798:Genes, Bacterial; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Clostridium difficile; antibiotics; biofilm; drug resistance; testing