Abstract
Introduction: Antimicrobial resistance (AMR) played an important role in the initial outbreaks of Clostridium difficile infection (CDI) in the 1970s. C. difficile ribotype (RT) 017 has emerged as the major strain of C. difficile in Asia, where antimicrobial use is poorly regulated. This strain has also caused CDI outbreaks around the world for almost 30 years. Many of these outbreaks were associated with clindamycin and fluoroquinolone resistance. AMR and selective pressure is likely to be responsible for the success of this RT and may drive future outbreaks.
Areas covered: This narrative journalarticle summarizes the prevalence and mechanisms of AMR in C. difficile RT 017 and transmission of these AMR mechanisms. To address these topics, reports of outbreaks due to C. difficile RT 017, epidemiologic studies with antimicrobial susceptibility results, studies on resistance mechanisms found in C. difficile and related publications available through Pubmed until September 2019 were collated and the findings discussed.
Expert opinion: Primary prevention is the key to control CDI. This should be achieved by developing antimicrobial stewardship in medical, veterinary and agricultural practices. AMR is the key factor that drives CDI outbreaks, and methods for the early detection of AMR can facilitate the control of outbreaks.
Keywords
Antimicrobial resistance, Clostridium difficile, outbreak, prevention, ribotype 017cadazolid, carbapenem, clindamycin, linezolid, quinoline derived antiinfective agent, rifaximin, tetracycline derivative, antibiotic resistance, bacterial genome, bacterial strain, bacterial transmission, Clostridioides difficile, epidemic, genome analysis, genotype, multidrug resistant Clostridioides difficile, nonhuman, point mutation, primary prevention, journalarticle
Document Type
Journal Article
Date of Publication
1-1-2020
Publication Title
Expert Review of Anti-Infective Therapy
Publisher
Taylor and Francis
School
School of Medical and Health Sciences
RAS ID
30359
Funding Information
K Imwattana is a recipient of Mahidol Scholarship from Mahidol University. D R Knight and D A Collins are recipients of the Early Career Fellowships from the National Health and Medical Research Council of Australia [APP1138257 and APP1156789]. B Kullin is a recipient of the Australia Awards Post-Doctoral Fellowship grant from Australia Africa University Network.
Funding received from the National Health and Medical Research Council (NHMRC)
1138257, GNT1156789
Administering Institution
Edith Cowan University
First Page
17
Content Type
Full object
Last Page
25
Recommended Citation
Imwattana, K., Knight, D. R., Kullin, B., Collins, D. A., Putsathit, P., Kiratisin, P., & Riley, T. V. (2020). Antimicrobial resistance in Clostridium difficile ribotype 017. Expert Review of Anti-infective Therapy, 18(1), 17-25. https://doi.org/10.1080/14787210.2020.1701436
Comments
This is an Accepted Manuscript of an article published by Taylor & Francis in Expert Review of Anti-infective Therapy on 6 December 2019, available online: http://www.tandfonline.com/10.1080/14787210.2020.1701436.
Imwattana, K., Knight, D. R., Kullin, B., Collins, D. A., Putsathit, P., Kiratisin, P., & Riley, T. V. (2020). Antimicrobial resistance in Clostridium difficile ribotype 017. Expert Review of Anti-infective Therapy, 18(1), 17-25. https://doi.org/10.1080/14787210.2020.1701436