scholarly journals Prevalence, genetic characterization, and antimicrobial resistance of Salmonella isolated from meat goats in the Northeastern region of Thailand

2021 ◽  
Vol 19 (3) ◽  
pp. 363-378
Author(s):  
Wattanasak Chamlakhorn ◽  
◽  
Patchara Phuektes ◽  
Seri Khang-Air ◽  
Sunpetch Angkititrakul ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Susceptibility ◽  
Antimicrobial Agents ◽  
Genetic Characterization ◽  
Genotypic Diversity ◽  
Resistance Pattern ◽  
Chromosomal Dna ◽  
Northeastern Region ◽  
Meat Goats ◽  
Broth Microdilution Method

This study aimed to determine the prevalence, genotypic diversity, and antimicrobial resistance pattern of Salmonella isolated from meat goats in the Northeastern region of Thailand. A total of 1,014 rectal swabs were collected from 30 meat goat farms during April to November, 2018. Salmonella was isolated and identified according to the International Organization for Standardization protocol (ISO-6579:2002/AMD:2017) and serotyped using a slide agglutination test following the Kauffmann-White scheme. An antimicrobial susceptibility test to determine minimal inhibitory concentration (MIC) of 12 antimicrobial agents was performed using a broth microdilution method following the CLSI protocol (2017). Pulsed-field gel electrophoresis (PFGE) of XbaI digested chromosomal DNA was used to determine genotypic diversity of the isolates. The overall prevalence of Salmonella in the meat goats was 1.28%. A total of 13 Salmonella isolates recovered from the meat goats belonged to 4 serovars includings. Weltevreden (n=4), S. Bovismorbificans (n=4), S. Paratyphi B (n=4), and S. Stanley (n=1). Antimicrobial susceptibility testing revealed 2 antibiogram patternS. Eleven Salmonella isolates were susceptible to all antimicrobial agents tested, except sulfamethoxazole, and the other 2 isolates were susceptible to all antimicrobials. Genetic characterization of 13 Salmonella isolates by PFGE revealed 9 PFGE patterns that were grouped into 4 major clusters, A, B, C and D, with an 80% similarity value. This study revealed a low prevalence of Salmonella in meat goats in the Northeastern region of Thailand. Salmonella isolates were susceptible to most antimicrobials tested, with a very high proportion of resistance to sulfamethoxazole being observed.

Antimicrobial Resistance in Campylobacter jejuni from Broilers and Broiler House Environments in Norway

2007 ◽  
Vol 70 (3) ◽  
pp. 736-738 ◽  
Author(s):  
M. NORSTRÖM ◽  
G. JOHNSEN ◽  
M. HOFSHAGEN ◽  
H. THARALDSEN ◽  
H. KRUSE
Keyword(s):  
Antimicrobial Resistance ◽  
Campylobacter Jejuni ◽  
Antimicrobial Susceptibility ◽  
Antimicrobial Agents ◽  
Monitoring Program ◽  
Outdoor Environment ◽  
Susceptibility Data ◽  
Microdilution Method ◽  
Broth Microdilution Method ◽  
Broiler House

Antimicrobial susceptibility in Campylobacter jejuni collected from the environment outside four broiler houses (n = 63) and from the environment inside these broiler houses (including broiler droppings) (n = 36) from May to September 2004 was studied and compared with isolates from Norwegian broilers analyzed within the frame of the Norwegian monitoring program of antimicrobial resistance in feed, food, and animals (NORM-VET) in 2004 (n = 75). The MICs of oxytetracycline, ampicillin, erythromycin, gentamicin, enrofloxacin, and nalidixic acid were obtained by the broth microdilution method VetMIC. The present study, which to our knowledge is the first Norwegian study on the occurrence of antimicrobial resistance in Campylobacter spp. from the environment of broiler houses, revealed a very low occurrence of antimicrobial resistance in C. jejuni from the broilers and broiler house environments studied. All isolates originating from the four broiler houses studied were susceptible to all the antimicrobial agents tested, except for one isolate from the outdoor environment (courtyard soil), which was resistant to oxytetracycline (MIC, 8 mg/liter). For the isolates from broilers (NORM-VET), low prevalences of resistance to oxytetracycline (1.3%) and ampicillin (4%) were observed. No quinolone resistance was observed. The results for the broiler isolates are in agreement with the earlier findings of a very low prevalence of resistance in Campylobacter from broilers in Norway, which reflects the low usage of antimicrobials in Norwegian broiler production. Furthermore, the present data are in accordance with antimicrobial susceptibility data for C. jejuni from domestically acquired human cases.

scholarly journals Optical Screening for Rapid Antimicrobial Susceptibility Testing and for Observation of Phenotypic Diversity among Strains of the Genetically Clonal Species Bacillus anthracis

2017 ◽  
Vol 55 (3) ◽  
pp. 959-970 ◽  
Author(s):  
Heather P. McLaughlin ◽  
Amy S. Gargis ◽  
Pierre Michel ◽  
David Sue ◽  
Linda M. Weigel
Keyword(s):  
Antimicrobial Resistance ◽  
Bacillus Anthracis ◽  
Antimicrobial Susceptibility ◽  
Antimicrobial Agents ◽  
Phenotypic Diversity ◽  
New Technology ◽  
Time Lapse ◽  
Growth Characteristics ◽  
Content Type ◽  
Broth Microdilution Method

ABSTRACTDuring high-impact events involvingBacillus anthracis, such as the Amerithrax incident of 2001 or the anthrax outbreaks in Russia and Sweden in 2016, critical decisions to reduce morbidity and mortality include rapid selection and distribution of effective antimicrobial agents for treatment and postexposure prophylaxis. Detection of antimicrobial resistance currently relies on a conventional broth microdilution method that requires a 16- to 20-h incubation time forB. anthracis. Advances in high-resolution optical screening offer a new technology to more rapidly evaluate antimicrobial susceptibility and to simultaneously assess the growth characteristics of an isolate. Herein, we describe a new method developed and evaluated as a rapid antimicrobial susceptibility test forB. anthracis. This method is based on automated digital time-lapse microscopy to observe the growth and morphological effects of relevant antibiotics with an optical screening instrument, the oCelloScope.B. anthracisstrains were monitored over time in the presence or absence of penicillin, ciprofloxacin, or doxycycline. Susceptibility to each antibiotic was determined in ≤4 h, 75 to 80% less than the time required for conventional methods. Time-lapse video imaging compiled from the optical screening images revealed unexpected differences in growth characteristics among strains ofB. anthracis, which is considered to be a clonal organism. This technology provides a new approach for rapidly detecting phenotypic antimicrobial resistance and for documenting growth attributes that may be beneficial in the further characterization of individual strains.

scholarly journals Molecular epidemiology and antimicrobial resistance of Salmonella isolates from broilers and pigs in Thailand

2019 ◽  
Vol 12 (8) ◽  
pp. 1311-1318 ◽  
Author(s):  
Dusadee Phongaran ◽  
Seri Khang-Air ◽  
Sunpetch Angkititrakul
Keyword(s):  
Antimicrobial Resistance ◽  
Gel Electrophoresis ◽  
Animal Species ◽  
Antimicrobial Agents ◽  
Genetic Relatedness ◽  
Pulsed Field Gel Electrophoresis ◽  
Resistance Pattern ◽  
Salmonella Spp ◽  
Pulsed Field ◽  
Amoxicillin Clavulanate

Aim: This study aimed to determine the prevalence and antimicrobial resistance pattern of Salmonella spp., and the genetic relatedness between isolates from broilers and pigs at slaughterhouses in Thailand. Materials and Methods: Fecal samples (604 broilers and 562 pigs) were collected from slaughterhouses from April to July 2018. Salmonella spp. were isolated and identified according to the ISO 6579:2002. Salmonella-positive isolates were identified using serotyping and challenged with nine antimicrobial agents: Amoxicillin/clavulanate (AMC, 30 μg), ampicillin (AMP, 10 μg), ceftazidime (30 μg), chloramphenicol (30 μg), ciprofloxacin (CIP, 5 μg), nalidixic acid (NAL, 30 μg), norfloxacin (10 μg), trimethoprim/sulfamethoxazole (SXT, 25 μg), and tetracycline (TET, 30 μg). Isolates of the predominant serovar Salmonella Typhimurium were examined for genetic relatedness using pulsed-field gel electrophoresis (PFGE). Results: Salmonella was detected in 18.05% of broiler isolates and 37.54% of pig isolates. The most common serovars were Kentucky, Give, and Typhimurium in broilers and Rissen, Typhimurium, and Weltevreden in pigs. Among broilers, isolates were most commonly resistant to antibiotics, NAL, AMP, TET, AMC, and CIP. Pig isolates most commonly exhibited antimicrobial resistance against AMP, TET, and SXT. Based on PFGE results among 52 S. Typhimurium isolates from broilers and pigs, a high genetic relatedness between broiler and pig isolates (85% similarity) in Cluster A and C from PFGE result was identified. Conclusion: The results revealed high cross-contamination between these two animal species across various provinces in Thailand. Keywords: antimicrobial resistance, broilers, pigs, pulsed-field gel electrophoresis, Salmonella spp.

scholarly journals Differences in Neisseria gonorrhoeae population structure and antimicrobial resistance pattern between men who have sex with men and heterosexuals

2016 ◽  
Vol 145 (2) ◽  
pp. 379-385 ◽  
Author(s):  
J. SERRA-PLADEVALL ◽  
M. J. BARBERÁ ◽  
A. E. CALLARISA ◽  
R. BARTOLOMÉ-COMAS ◽  
A. ANDREU
Keyword(s):  
Population Structure ◽  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Antimicrobial Susceptibility ◽  
Sexual Practices ◽  
Resistance Pattern ◽  
High Prevalence ◽  
Sex With Men ◽  
Resistance Rates ◽  
Sequence Types

SUMMARYThis study compared the antimicrobial susceptibility and genotypes of strains of Neisseria gonorrhoeae isolated from men who have sex with men (MSM) and from heterosexuals. One hundred and eleven strains were characterized from 107 patients, comprising 57 strains from 54 heterosexuals and 54 strains from 53 MSM. Antimicrobial resistance rates were higher in strains from heterosexual patients, with resistance to cefixime (P = 0·0159) and ciprofloxacin (P = 0·002) being significantly higher. Typing by N. gonorrhoeae multi-antigen sequence typing (NG-MAST) showed that the most prevalent sequence types (ST) and genogroups (G) respectively were ST2400, ST2992, and ST5793, and G1407, G2992, and G2400. A statistically significant association was observed for MSM and genogroups G2400 (P = 0·0005) and G2992 (P = 0·0488), and G1407 with heterosexuals (P = 0·0002). We conclude that in our region distinct populations of gonococci are circulating among subjects with different sexual practices, with their corresponding transmission patterns. Furthermore, the high prevalence of genotype G2400 in MSM, has not to our knowledge been previously described.

scholarly journals Characterization of Multidrug Resistance Patterns of Emerging Salmonella enterica Serovar Rissen along the Food Chain in China

Antibiotics ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 660
Author(s):  
Xuebin Xu ◽  
Silpak Biswas ◽  
Guimin Gu ◽  
Mohammed Elbediwi ◽  
Yan Li ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Foodborne Pathogens ◽  
Food Chain ◽  
Salmonella Enterica ◽  
Antimicrobial Agents ◽  
Animal Husbandry ◽  
Multidrug Resistant ◽  
Salmonella Spp ◽  
Broth Microdilution Method ◽  
Resistance Patterns

Salmonella spp. are recognized as important foodborne pathogens globally. Salmonella enterica serovar Rissen is one of the important Salmonella serovars linked with swine products in numerous countries and can transmit to humans by food chain contamination. Worldwide emerging S. Rissen is considered as one of the most common pathogens to cause human salmonellosis. The objective of this study was to determine the antimicrobial resistance properties and patterns of Salmonella Rissen isolates obtained from humans, animals, animal-derived food products, and the environment in China. Between 2016 and 2019, a total of 311 S. Rissen isolates from different provinces or province-level cities in China were included here. Bacterial isolates were characterized by serotyping and antimicrobial susceptibility testing. Minimum inhibitory concentration (MIC) values of 14 clinically relevant antimicrobials were obtained by broth microdilution method. S. Rissen isolates from humans were found dominant (67%; 208/311). S. Rissen isolates obtained from human patients were mostly found with diarrhea. Other S. Rissen isolates were acquired from food (22%; 69/311), animals (8%; 25/311), and the environment (3%; 9/311). Most of the isolates were resistant to tetracycline, trimethoprim-sulfamethoxazole, chloramphenicol, streptomycin, sulfisoxazole, and ampicillin. The S. Rissen isolates showed susceptibility against ceftriaxone, ceftiofur, gentamicin, nalidixic acid, ciprofloxacin, and azithromycin. In total, 92% of the S. Rissen isolates were multidrug-resistant and ASSuT (27%), ACT (25%), ACSSuT (22%), ACSSuTAmc (11%), and ACSSuTFox (7%) patterns were among the most prevalent antibiotic resistance patterns found in this study. The widespread dissemination of antimicrobial resistance could have emerged from misuse of antimicrobial agents in animal husbandry in China. These findings could be useful for rational antimicrobial usage against Salmonella Rissen infections.

Characterization of Toxin Genes and Antimicrobial Susceptibility of Staphylococcus aureus from Retail Raw Chicken Meat

2018 ◽  
Vol 81 (4) ◽  
pp. 528-533 ◽  
Author(s):  
SUIXIA LI ◽  
PANPAN WANG ◽  
JIALIN ZHAO ◽  
LUHONG ZHOU ◽  
PENGFEI ZHANG ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Antimicrobial Susceptibility ◽  
Antimicrobial Agents ◽  
Health Hazard ◽  
Toxin Gene ◽  
Potential Health ◽  
Toxin Genes ◽  
Genes Encoding ◽  
Potential Health Hazard

ABSTRACTThe aim of this study was to investigate the toxin gene profile and antimicrobial resistance of Staphylococcus aureus isolates from raw chicken in the People's Republic of China. In total, 289 S. aureus isolates were characterized by antimicrobial susceptibility testing, and genes encoding enterotoxins, exfoliative toxins, Panton-Valentine leukocidin, and toxic shock syndrome toxin were revealed by PCR. Overall, 46.0% of the isolates were positive for one or more toxin genes. A high proportion of toxin genes were pvl (26.6%), followed by sej (12.5%), sea (9.0%), seh (8.3%), seb (6.9%), sec (6.9%), sed (4.8%), sei (3.1%), and see (2.4%). None of the isolates harbored seg, tsst-1, or exfoliative toxin genes. In total, 29 toxin gene profiles were obtained, and pvl (10.7%) was the most frequent genotype, followed by sea (5.9%), seb (4.8%), and sej (4.2%). Furthermore, 99.7% of the strains were resistant to at least one of the tested antimicrobial agents, and 87.2% of them displayed multidrug resistance. Resistance was most frequently observed to trimethoprim-sulfamethoxazole and erythromycin (86.2% for each), followed by tetracycline (69.9%), amoxicillin–clavulanic acid (45.0%), and ampicillin (42.6%). None of the strains were resistant to vancomycin. This study indicates that S. aureus isolates from raw chicken harbored multiple toxin genes and exhibited multiple antimicrobial resistance, which represents a potential health hazard for consumers.

scholarly journals Antimicrobial susceptibility profiles of Staphylococcus intermedius isolates from clinical cases of canine pyoderma in South Africa

2013 ◽  
Vol 84 (1) ◽  
Author(s):  
Catherine A. Blunt ◽  
Moritz Van Vuuren ◽  
Jacqueline Picard
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Susceptibility ◽  
Bacterial Resistance ◽  
Antimicrobial Agents ◽  
Temporal Trends ◽  
Companion Animals ◽  
Diagnostic Laboratory ◽  
Staphylococcus Intermedius ◽  
Susceptibility Profiles ◽  
Broth Dilution

Successful treatment of canine pyoderma has become compromised owing to the development of antimicrobial resistance with accompanying recurrence of infection. Canine skin samples submitted to a veterinary diagnostic laboratory for microbiological culture and sensitivity between January 2007 and June 2010, from which Staphylococcus intermedius was isolated, were selected for this investigation. Antimicrobial resistance of S. intermedius was most prevalent with reference to ampicillin followed by resistance to tetracycline and then potentiated sulphonamides. In general, antimicrobial resistance was low and very few methicillin-resistant isolates were detected. Temporal trends were not noted, except for ampicillin, with isolates becoming more susceptible, and potentiated sulphonamides (co-trimoxazole), with isolates becoming more resistant. In general, both the Kirby–Bauer disc diffusion and broth dilution minimum inhibitory concentration tests yielded similar results for the antimicrobial agents tested. The main difference was evident in the over-estimation of resistance by the Kirby–Bauer test for ampicillin, co-trimoxazole, penicillin and doxycycline. Knowledge of trends in bacterial resistance is important for veterinarians when presented with canine pyoderma. Analysis of antimicrobial susceptibility profiles of S. intermedius isolated from canine pyodermas will guide veterinarians’ use of the most appropriate agent and encourage prudent use of antimicrobials in companion animals.

scholarly journals Antimicrobial Resistance in Bacteria Isolated From Cats and Dogs From the Iberian Peninsula

2021 ◽  
Vol 11 ◽  
Author(s):  
Yanli Li ◽  
Rubén Fernández ◽  
Inma Durán ◽  
Rafael A. Molina-López ◽  
Laila Darwich
Keyword(s):  
Antimicrobial Resistance ◽  
Respiratory Tract ◽  
Iberian Peninsula ◽  
Antimicrobial Susceptibility ◽  
Respiratory Tract Infections ◽  
Antimicrobial Agents ◽  
Close Contact ◽  
Clinical Samples ◽  
Private Laboratory ◽  
Tract Infections

Pet animals are assumed to be potential reservoirs in transferring antimicrobial resistance (AMR) to humans due to the extensively applied broad-spectrum antimicrobial agents and their close contact with humans. In this study, microbiological data and antimicrobial susceptibility results of dog (n = 5,086) and cat (n = 789) clinical samples from a private Laboratory of Diagnosis in Barcelona were analyzed. Samples came from different counties of the Iberian Peninsula during 2016–2018. In dogs, clinical samples were most commonly from otitis, and in cats from wounds, respiratory tract infections and conjunctivitis. In both pet groups, Staphylococcus spp. (31% in dogs vs 30% in cats), Streptococcus spp. (19% vs 17%), Pseudomonas spp. (16% vs 10%), Escherichia coli (8% vs 5.6%), and Enterococcus spp. (5.5% vs 6.8%) were shown as the most predominant bacteria. However, higher frequencies of P. aeruginosa, P. canis, and S. pseudintermedius were found in dogs, while S. aureus and P. multocida were more prevalent in cats. The antimicrobial susceptibility testing demonstrated that Enterococcus spp. and Pseudomonas spp. presented the highest levels of AMR in both dogs and cats. Within the Enterobacteriaceae, E. coli showed low levels of AMR compared to Klebsiella, Proteus, or Enterobacter spp. Respiratory tract infections caused by K. pneumoniae presented higher AMR in cats. By contrast, Pasteurella isolates from the respiratory tract were highly sensitive to all the antimicrobials in cats and dogs. Data from this study could be used to guide empirical antimicrobial selection in companion animal veterinary practices in the Iberian Peninsula.

scholarly journals Retrospective study on susceptibility and resistance pattern of urinary pathogens in a tertiary care hospital

2019 ◽  
Vol 8 (10) ◽  
pp. 2211
Author(s):  
Sudha Ramu
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Agents ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Empirical Therapy ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Surveillance Program ◽  
Care Hospital ◽  
Susceptibility And Resistance

Background: Indiscriminate and inappropriate use of antimicrobial agents (AMA) resulted in rapid emergence of antimicrobial resistance. Institutional level surveillance program to be carried out to track AMA use. The study was conducted to evaluate the prevalence of uropathogens and their susceptibility and resistance pattern in a tertiary care hospital to revise empirical therapy.Methods: Urine samples received from the inpatients and outpatients Departments of Mahatma Gandhi memorial hospital for culture sensitivity between January 2018 to December 2018 were included in this study. Data collected from the Department of Microbiology register by using WHONET software. After identification, isolates were tested for antimicrobial susceptibility by the standard Kirby Bauers diffusion method. Descriptive analysis done and results were expressed as percentage.Results: Out of 3425 samples 68.5% showed no growth, 15.5% normal flora and only 15.9% reported as culture positive. In this study the highest isolate was Escherichia coli (59%) followed by Klebsiella pneumoniae (10.6%), Enterococcus sp. (7%), Staphylococcus aureus (5%), Candid (3.6%), Acinetobactor (3%) and Pseudomonas (2.9%). Uropathogens developed resistance against penicillins, cephalosporins, macrolides and cotrimaxazole.Conclusions: This study confirms, the frequently prescribed empirical therapy drugs were less susceptible and developed resistance than less frequently prescribed and costly drugs. The current antimicrobial resistance pattern alarms the irrational and excessive use of antimicrobial agents. Hence the treating physicians should revise empirical therapy periodically based on the institutional antibiogram and resistance pattern reported from the laboratory to preserve antimicrobial source for the future generation.

scholarly journals Prevalence and antimicrobial resistance pattern of Clostridium difficile among hospitalized diarrheal patients: A systematic review and meta-analysis

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262597
Author(s):  
Tebelay Dilnessa ◽  
Alem Getaneh ◽  
Workagegnehu Hailu ◽  
Feleke Moges ◽  
Baye Gelaw
Keyword(s):  
Systematic Review ◽  
Clostridium Difficile ◽  
Antimicrobial Resistance ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Meta Analysis ◽  
Antimicrobial Susceptibility Testing ◽  
Prevalence Study ◽  
Resistance Pattern ◽  
Pooled Prevalence

Background Clostridium difficile is the leading cause of infectious diarrhea that develops in patients after hospitalization during antibiotic administration. It has also become a big issue in community-acquired diarrhea. The emergence of hypervirulent strains of C. difficile poses a major problem in hospital-associated diarrhea outbreaks and it is difficult to treat. The antimicrobial resistance in C. difficile has worsened due to the inappropriate use of broad-spectrum antibiotics including cephalosporins, clindamycin, tetracycline, and fluoroquinolones together with the emergence of hypervirulent strains. Objective To estimate the pooled prevalence and antimicrobial resistance pattern of C. difficile derived from hospitalized diarrheal patients, a systematic review and meta-analysis was performed. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed to review published studies conducted. We searched bibliographic databases from PubMed, Scopus, Google Scholar, and Cochrane Library for studies on the prevalence and antimicrobial susceptibility testing on C. difficile. The weighted pooled prevalence and resistance for each antimicrobial agent was calculated using a random-effects model. A funnel plot and Egger’s regression test were used to see publication bias. Results A total of 15 studies were included. Ten articles for prevalence study and 5 additional studies for antimicrobial susceptibility testing of C. difficile were included. A total of 1967/7852 (25%) C. difficile were isolated from 10 included studies for prevalence study. The overall weighted pooled proportion (WPP) of C. difficile was 30% (95% CI: 10.0–49.0; p<0.001). The analysis showed substantial heterogeneity among studies (Cochran’s test = 7038.73, I2 = 99.87%; p<0.001). The weighed pooled antimicrobial resistance (WPR) were: vancomycin 3%(95% CI: 1.0–4.0, p<0.001); metronidazole 5%(95% CI: 3.0–7.0, p<0.001); clindamycin 61%(95% CI: 52.0–69.0, p<0.001); moxifloxacin 42%(95% CI: 29–54, p<0.001); tetracycline 35%(95% CI: 22–49, p<0.001); erythromycin 61%(95% CI: 48–75, p<0.001) and ciprofloxacin 64%(95% CI: 48–80; p< 0.001) using the random effect model. Conclusions A higher weighted pooled prevalence of C. difficile was observed. It needs a great deal of attention to decrease the prevailing prevalence. The resistance of C. difficile to metronidazole and vancomycin was low compared to other drugs used to treat C. difficile infection. Periodic antimicrobial resistance monitoring is vital for appropriate therapy of C. difficile infection.

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