Haem is crucial for medium-dependent metronidazole resistance in clinical isolates of Clostridioides difficile.
J Antimicrob Chemother
; 76(7): 1731-1740, 2021 06 18.
Article
in En
| MEDLINE
| ID: mdl-33876817
ABSTRACT
BACKGROUND:
Until recently, metronidazole was the first-line treatment for Clostridioides difficile infection and it is still commonly used. Though resistance has been reported due to the plasmid pCD-METRO, this does not explain all cases.OBJECTIVES:
To identify factors that contribute to plasmid-independent metronidazole resistance of C. difficile.METHODS:
Here, we investigate resistance to metronidazole in a collection of clinical isolates of C. difficile using a combination of antimicrobial susceptibility testing on different solid agar media and WGS of selected isolates.RESULTS:
We find that nearly all isolates demonstrate a haem-dependent increase in the MIC of metronidazole, which in some cases leads to isolates qualifying as resistant (MIC >2 mg/L). Moreover, we find an SNP in the haem-responsive gene hsmA, which defines a metronidazole-resistant lineage of PCR ribotype 010/MLST ST15 isolates that also includes pCD-METRO-containing strains.CONCLUSIONS:
Our data demonstrate that haem is crucial for medium-dependent metronidazole resistance in C. difficile.
Full text:
1
Database:
MEDLINE
Main subject:
Clostridioides difficile
/
Clostridium Infections
Type of study:
Prognostic_studies
Limits:
Humans
Language:
En
Journal:
J Antimicrob Chemother
Year:
2021
Type:
Article
Affiliation country:
Netherlands