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dc.contributor.authorBoekhoud, Ilse M
dc.contributor.authorHornung, Bastian V H
dc.contributor.authorSevilla, Eloisa
dc.contributor.authorHarmanus, Céline
dc.contributor.authorBos-Sanders, Ingrid M J G
dc.contributor.authorTerveer, Elisabeth M
dc.contributor.authorBolea, Rosa
dc.contributor.authorCorver, Jeroen
dc.contributor.authorKuijper, Ed J
dc.contributor.authorSmits, Wiep Klaas
dc.date.accessioned2020-08-16T15:48:45Z
dc.date.available2020-08-16T15:48:45Z
dc.date.issued2020-01-30
dc.identifier.issn2041-1723
dc.identifier.pmid32001686
dc.identifier.doi10.1038/s41467-020-14382-1
dc.identifier.urihttp://hdl.handle.net/10029/624115
dc.description.abstractMetronidazole was until recently used as a first-line treatment for potentially life-threatening Clostridioides difficile (CD) infection. Although cases of metronidazole resistance have been documented, no clear mechanism for metronidazole resistance or a role for plasmids in antimicrobial resistance has been described for CD. Here, we report genome sequences of seven susceptible and sixteen resistant CD isolates from human and animal sources, including isolates from a patient with recurrent CD infection by a PCR ribotype (RT) 020 strain, which developed resistance to metronidazole over the course of treatment (minimal inhibitory concentration [MIC] = 8 mg L-1). Metronidazole resistance correlates with the presence of a 7-kb plasmid, pCD-METRO. pCD-METRO is present in toxigenic and non-toxigenic resistant (n = 23), but not susceptible (n = 563), isolates from multiple countries. Introduction of a pCD-METRO-derived vector into a susceptible strain increases the MIC 25-fold. Our finding of plasmid-mediated resistance can impact diagnostics and treatment of CD infections.en_US
dc.language.isoenen_US
dc.titlePlasmid-mediated metronidazole resistance in Clostridioides difficile.en_US
dc.typeArticleen_US
dc.identifier.journalNat Commun 2020; 11(1):598en_US
dc.source.journaltitleNature communications


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