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Antimicrobial resistance in Clostridioides difficile

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Abstract

Antimicrobial resistance (AMR) in Clostridioides difficile remains a significant threat to global healthcare systems, not just for the treatment of C. difficile infection (CDI), but as a reservoir of AMR genes that could be potentially transferred to other pathogens. The mechanisms of resistance for several antimicrobials such as metronidazole and MLSB-class agents are only beginning to be elucidated, and increasingly, there is evidence that previously unconsidered mechanisms such as plasmid-mediated resistance may play an important role in AMR in this bacterium. In this review, the genetics of AMR in C. difficile will be described, along with a discussion of the factors contributing to the difficulty in clearly determining the true burden of AMR in C. difficile and how it affects the treatment of CDI.

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Funding

K.O. is funded by an Australian Government Research Training Program Scholarship. D.R.K. is funded by a Fellowship from the National Health and Medical Research Council (APP1138257) and a grant from the Raine Medical Research Foundation (RPG002-19).

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  1. Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, Murdoch, Western Australia, Australia

    Keeley O’Grady, Daniel R. Knight & Thomas V. Riley

  2. Marshall Centre for Infectious Diseases Research and Training, School of Biomedical Sciences, The University of Western Australia, Queen Elizabeth II Medical Centre, Nedlands, WA, 6009, Australia

    Daniel R. Knight & Thomas V. Riley

  3. School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia

    Thomas V. Riley

  4. Department of Microbiology, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Nedlands, WA, Australia

    Thomas V. Riley

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O’Grady, K., Knight, D.R. & Riley, T.V. Antimicrobial resistance in Clostridioides difficile. Eur J Clin Microbiol Infect Dis 40, 2459–2478 (2021). https://doi.org/10.1007/s10096-021-04311-5

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