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Related Experiment Video

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A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
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Antimicrobial resistance in Clostridium difficile ribotype 017.

Korakrit Imwattana1,2, Daniel R Knight3, Brian Kullin4

  • 1School of Biomedical Sciences, The University of Western Australia, Crawley, Australia.

Expert Review of Anti-Infective Therapy
|December 5, 2019
PubMed
Summary

Antimicrobial resistance (AMR) drives Clostridium difficile infection (CDI) outbreaks, particularly with the prevalent C. difficile RT 017 strain. Controlling CDI requires antimicrobial stewardship and early detection of AMR.

Keywords:
Antimicrobial resistanceClostridium difficileoutbreakpreventionribotype 017

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Area of Science:

  • Microbiology
  • Infectious Diseases
  • Epidemiology

Background:

  • Antimicrobial resistance (AMR) has been linked to Clostridium difficile infection (CDI) outbreaks since the 1970s.
  • Clostridium difficile ribotype (RT) 017 is a significant global strain, prevalent in Asia due to unregulated antimicrobial use.
  • This strain is associated with clindamycin and fluoroquinolone resistance, driving CDI outbreaks worldwide.

Purpose of the Study:

  • To review the prevalence and mechanisms of AMR in C. difficile RT 017.
  • To examine the transmission of AMR mechanisms within C. difficile.
  • To discuss the role of AMR in driving CDI outbreaks.

Main Methods:

  • A narrative review of publications on C. difficile RT 017 outbreaks and AMR.
  • Inclusion of epidemiologic studies with antimicrobial susceptibility data.
  • Analysis of studies on C. difficile resistance mechanisms up to September 2019.

Main Results:

  • C. difficile RT 017 exhibits significant AMR, particularly to clindamycin and fluoroquinolones.
  • AMR and selective pressure are key factors in the success and spread of this strain.
  • Outbreaks of CDI are strongly associated with AMR in C. difficile strains.

Conclusions:

  • Primary prevention through antimicrobial stewardship in medical, veterinary, and agricultural practices is crucial for CDI control.
  • AMR is a primary driver of CDI outbreaks.
  • Early detection of AMR facilitates effective outbreak control strategies.