{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T22:25:45Z","timestamp":1794349545883,"version":"4.9.0"},"reference-count":48,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100023448","name":"Robert Koch Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100023448","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Medical Microbiology"],"published-print":{"date-parts":[[2026,12]]},"DOI":"10.1016\/j.ijmm.2026.151742","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T15:44:23Z","timestamp":1790351063000},"page":"151742","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Tracking Clostridioides difficile in Germany: Active prospective surveillance progress and molecular epidemiological trends"],"prefix":"10.1016","volume":"323","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5029-6223","authenticated-orcid":false,"given":"Ahmed Mostafa","family":"Abdrabou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia S.","family":"Schneider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian K.","family":"Berger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Bischoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lutz von","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0649-5185","authenticated-orcid":false,"given":"Alexander","family":"Mellmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara C.","family":"G\u00e4rtner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinhard","family":"Hoffmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeska","family":"Simon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"B\u00fcchler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frieder","family":"Schaumburg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Schoeler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen Benjamin","family":"Hagemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatjana Magdalena","family":"Wolffhardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Bohne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Gro\u00df","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Ulm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karsten","family":"Becker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Dziobaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Buer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Pauly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas E.","family":"Zautner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achim J.","family":"Kaasch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Tarek","family":"Badr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Forster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thi\u00ean-Tr\u00ed","family":"L\u00e2m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlis","family":"Gerigk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Trimborn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Hamprecht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josef","family":"Hellkamp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Friedrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Despina","family":"Papadopoulou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jette","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Weikert-Asbeck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Maschkowitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronika","family":"Neumayr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"H\u00e4cker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bochum","family":"GmbH","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Schmiedel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz","family":"Fritzenwanker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josef","family":"S\u00e4gm\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duesseldorf Medical","family":"Laboratories","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard","family":"Haase","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helga","family":"Haefner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catalina-Suzana","family":"Stingu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine","family":"Dietze-Jergus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Wolf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Technische Universit\u00e4t","family":"Dresden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u00fcsseldorf University","family":"Hospital","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Burbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hogardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ijmm.2026.151742_bib1","doi-asserted-by":"crossref","DOI":"10.1016\/j.anaerobe.2022.102548","article-title":"Implementation of a Clostridioides difficile sentinel surveillance system in Germany: first insights for 2019\u20132021","volume":"77","author":"Abdrabou","year":"2022","journal-title":"Anaerobe"},{"issue":"4","key":"10.1016\/j.ijmm.2026.151742_bib2","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijmm.2021.151507","article-title":"Molecular epidemiology and antimicrobial resistance of Clostridioides difficile in Germany, 2014\u20132019","volume":"311","author":"Abdrabou","year":"2021","journal-title":"Int. J. Med. Microbiol."},{"issue":"8","key":"10.1016\/j.ijmm.2026.151742_bib3","doi-asserted-by":"crossref","DOI":"10.3390\/pathogens11080949","article-title":"Antibiotic resistance profile of RT 027\/176 versus other Clostridioides difficile isolates in Silesia, Southern Poland","volume":"11","author":"Aptekorz","year":"2022","journal-title":"Pathogens"},{"issue":"10","key":"10.1016\/j.ijmm.2026.151742_bib4","doi-asserted-by":"crossref","DOI":"10.2807\/1560-7917.ES2014.19.10.20732","article-title":"Increased incidence of Clostridium difficile PCR ribotype 027 in Hesse, Germany, 2011\u20132013","volume":"19","author":"Arvand","year":"2014","journal-title":"Eur. Surveill."},{"issue":"5","key":"10.1016\/j.ijmm.2026.151742_bib5","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1007\/s12223-017-0515-x","article-title":"Molecular typing and antimicrobial susceptibility testing to six antimicrobials of Clostridium difficile isolates from three Czech hospitals in Eastern Bohemia in 2011-2012","volume":"62","author":"Beran","year":"2017","journal-title":"Folia Microbiol. (Praha)"},{"issue":"4","key":"10.1016\/j.ijmm.2026.151742_bib6","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1007\/s40121-023-00785-2","article-title":"Epidemiology of Clostridioides difficile infections in Germany, 2010-2019: a review from four public databases","volume":"12","author":"Brestrich","year":"2023","journal-title":"Infect. Dis. Ther."},{"issue":"1","key":"10.1016\/j.ijmm.2026.151742_bib7","doi-asserted-by":"crossref","DOI":"10.1080\/21505594.2022.2150452","article-title":"Pathogenicity and virulence of Clostridioides difficile","volume":"14","author":"Buddle","year":"2023","journal-title":"Virulence"},{"issue":"4","key":"10.1016\/j.ijmm.2026.151742_bib8","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1556\/030.2024.02401","article-title":"Epidemiology of Clostridioides difficile PCR ribotype 181 after the COVID-19 pandemic in Northern Greece","volume":"71","author":"Charisi","year":"2024","journal-title":"Acta Microbiol. Immunol. Hung."},{"key":"10.1016\/j.ijmm.2026.151742_bib9","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/978-3-031-42108-2_8","article-title":"Ribotypes and new virulent strains across Europe","volume":"1435","author":"Couturier","year":"2024","journal-title":"Adv. Exp. Med. Biol."},{"issue":"4","key":"10.1016\/j.ijmm.2026.151742_bib10","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/S1473-3099(16)30514-X","article-title":"Effects of control interventions on Clostridium difficile infection in England: an observational study","volume":"17","author":"Dingle","year":"2017","journal-title":"Lancet Infect. Dis."},{"issue":"1","key":"10.1016\/j.ijmm.2026.151742_bib11","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1186\/s13756-025-01565-y","article-title":"Whole genome sequence analysis reveals limited diversity among Clostridioides difficile ribotype 027 and 078 isolates collected in 22 hospitals in Berlin and Brandenburg, Germany","volume":"14","author":"Dirks","year":"2025","journal-title":"Antimicrob. Resist. & Infect. Control."},{"key":"10.1016\/j.ijmm.2026.151742_bib12","unstructured":"European Committee on Antimicrobial Susceptibility Testing (EUCAST). (2026). Microbiological breakpoints. Retrieved from: https:\/\/www.eucast.org\/fileadmin\/eucast\/pdf\/breakpoints\/v_16.0_Breakpoint_Tables.pdf. Last accessed 13.06.2026."},{"key":"10.1016\/j.ijmm.2026.151742_bib13","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s13756-017-0181-4","article-title":"Management of a cluster of Clostridium difficile infections among patients with osteoarticular infections","volume":"6","author":"F\u00e4rber","year":"2017","journal-title":"Antimicrob. Resist. Infect. Control."},{"issue":"7","key":"10.1016\/j.ijmm.2026.151742_bib14","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1016\/j.cmi.2017.10.008","article-title":"The ClosER study: results from a three-year pan-European longitudinal surveillance of antibiotic resistance among prevalent Clostridium difficile ribotypes, 2011-2014","volume":"24","author":"Freeman","year":"2018","journal-title":"Clin. Microbiol. Infect."},{"issue":"1","key":"10.1016\/j.ijmm.2026.151742_bib15","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1007\/s10096-019-03708-7","article-title":"Five-year Pan-European, longitudinal surveillance of Clostridium difficile ribotype prevalence and antimicrobial resistance: the extended ClosER study","volume":"39","author":"Freeman","year":"2020","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"issue":"1","key":"10.1016\/j.ijmm.2026.151742_bib16","doi-asserted-by":"crossref","first-page":"15","DOI":"10.4161\/gmic.26854","article-title":"Clostridium difficile binary toxin CDT: mechanism, epidemiology, and potential clinical importance","volume":"5","author":"Gerding","year":"2014","journal-title":"Gut Microbes"},{"issue":"5","key":"10.1016\/j.ijmm.2026.151742_bib17","doi-asserted-by":"crossref","first-page":"e1029","DOI":"10.1093\/cid\/ciab549","article-title":"Clinical practice guideline by the infectious diseases society of America (IDSA) and society for healthcare epidemiology of america (shea): 2021 focused update guidelines on management of Clostridioides difficile infection in adults","volume":"73","author":"Johnson","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"10.1016\/j.ijmm.2026.151742_bib18","doi-asserted-by":"crossref","DOI":"10.1016\/j.anaerobe.2020.102252","article-title":"An outbreak of Clostridioides difficile infections due to a 027-like PCR ribotype 181 in a rehabilitation centre: Epidemiological and microbiological characteristics","volume":"65","author":"Kachrimanidou","year":"2020","journal-title":"Anaerobe"},{"issue":"3","key":"10.1016\/j.ijmm.2026.151742_bib19","doi-asserted-by":"crossref","first-page":"306","DOI":"10.3343\/alm.2015.35.3.306","article-title":"Multiplex Real-Time PCR Method for Simultaneous Identification and Toxigenic Type Characterization of Clostridium difficile From Stool Samples","volume":"35","author":"Kilic","year":"2015","journal-title":"Ann. Lab. Med."},{"issue":"4","key":"10.1016\/j.ijmm.2026.151742_bib20","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1017\/ice.2023.18","article-title":"Strategies to prevent Clostridioides difficile infections in acute-care hospitals: 2022 Update","volume":"44","author":"Kociolek","year":"2023","journal-title":"Infect. Control. Hosp. Epidemiol."},{"issue":"29","key":"10.1016\/j.ijmm.2026.151742_bib21","doi-asserted-by":"crossref","DOI":"10.2807\/1560-7917.ES.2016.21.29.30296","article-title":"Clostridium difficile PCR ribotypes 001 and 176 - the common denominator of C. difficile infection epidemiology in the Czech Republic, 2014","volume":"21","author":"Krutova","year":"2016","journal-title":"Eur. Surveill."},{"key":"10.1016\/j.ijmm.2026.151742_bib22","doi-asserted-by":"crossref","DOI":"10.1016\/j.medmic.2024.100106","article-title":"Antibiotics and the gut microbiome: Understanding the impact on human health","volume":"20","author":"Lathakumari","year":"2024","journal-title":"Med. Microecol."},{"issue":"2","key":"10.1016\/j.ijmm.2026.151742_bib23","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/S1473-3099(16)30397-8","article-title":"Effect of a national 4C antibiotic stewardship intervention on the clinical and molecular epidemiology of Clostridium difficile infections in a region of Scotland: a non-linear time-series analysis","volume":"17","author":"Lawes","year":"2017","journal-title":"Lancet Infect. Dis."},{"key":"10.1016\/j.ijmm.2026.151742_bib24","unstructured":"Leiden University Medical Centre, Department of Medical Microbiology (LUMC), & Centre for Infectious Disease Control (CIb), RIVM, Bilthoven (2021). Fourteenth Annual Report of the National Reference Laboratory for Clostridioides difficile and results of the sentinel surveillance May 2019 - Jan 2021. https:\/\/www.rivm.nl\/sites\/default\/files\/2021-11\/Annual%20report%20C.%20difficile%20reference%20laboratory%20may%202019-jan%202021.pdf. Last accessed 13.06.2026."},{"issue":"7","key":"10.1016\/j.ijmm.2026.151742_bib25","article-title":"Insights into the Evolving Epidemiology of Clostridioides difficile Infection and Treatment: A Global Perspective","volume":"12","author":"Liu","year":"2023","journal-title":"Antibiot. (Basel)"},{"issue":"3","key":"10.1016\/j.ijmm.2026.151742_bib26","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","article-title":"Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance","volume":"18","author":"Magiorakos","year":"2012","journal-title":"Clin. Microbiol. Infect."},{"issue":"4","key":"10.1016\/j.ijmm.2026.151742_bib27","article-title":"The largely unnoticed spread of Clostridioides difficile PCR ribotype 027 in Germany after 2010","volume":"2","author":"Marujo","year":"2020","journal-title":"Infect. Prev. Pract."},{"issue":"4","key":"10.1016\/j.ijmm.2026.151742_bib28","first-page":"479","article-title":"Gut microbiota modulation and prevention of dysbiosis as an alternative approach to antimicrobial resistance: a narrative review","volume":"95","author":"Matzaras","year":"2022","journal-title":"Yale J. Biol. Med."},{"key":"10.1016\/j.ijmm.2026.151742_bib29","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.ijid.2019.10.038","article-title":"The emergence of Clostridium difficile ribotypes 027 and 176 with a predominance of the Clostridium difficile ribotype 001 recognized in Slovakia following the European standardized Clostridium difficile infection surveillance of 2016","volume":"90","author":"Novakova","year":"2020","journal-title":"Int. J. Infect. Dis."},{"issue":"1","key":"10.1016\/j.ijmm.2026.151742_bib30","doi-asserted-by":"crossref","first-page":"4130","DOI":"10.1038\/s41467-023-39429-x","article-title":"Decoding a cryptic mechanism of metronidazole resistance among globally disseminated fluoroquinolone-resistant Clostridioides difficile","volume":"14","author":"Olaitan","year":"2023","journal-title":"Nat. Commun."},{"issue":"49","key":"10.1016\/j.ijmm.2026.151742_bib31","doi-asserted-by":"crossref","DOI":"10.2807\/1560-7917.ES.2022.27.49.2200244","article-title":"Sentinel surveillance and epidemiology of Clostridioides difficile in Denmark, 2016\u20132019","volume":"27","author":"Persson","year":"2022","journal-title":"Eur. Surveill."},{"issue":"4","key":"10.1016\/j.ijmm.2026.151742_bib32","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1007\/s00284-019-01654-3","article-title":"Changes in Clostridium (Clostridioides) difficile PCR-ribotype distribution and antimicrobial resistance in a german tertiary care hospital over the last 10 years","volume":"76","author":"Piepenbrock","year":"2019","journal-title":"Curr. Microbiol."},{"key":"10.1016\/j.ijmm.2026.151742_bib33","unstructured":"Reichel, J., & Heger, F. (2024). Nationale Referenzzentrale f\u00fcr Clostridioides difficile, Jahresbericht 2024. Retrieved 09.06.2026 from https:\/\/www.ages.at\/download\/sdl-eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJpYXQiOjE2MDk0NTkyMDAsImV4cCI6NDA3MDkwODgwMCwidXNlciI6MCwiZ3JvdXBzIjpbMCwtMV0sImZpbGUiOiJmaWxlYWRtaW4vQUdFU18yMDIyLzJfTUVOU0NIL0tyYW5raGVpdC9LcmFua2hlaXRzZXJyZWdlci9DbG9zdHJpZG9pZGVzX2RpZmZpY2lsZS8yMDI0X0NEX0phaHJlc2JlcmljaHQucGRmIiwicGFnZSI6MTMxMH0.4qyjDoikd9N2uDzsxu8DK6QCcBO8lurH5RT0inbakAU\/2024_CD_Jahresbericht.pdf. Last accessed 13.06.2026."},{"key":"10.1016\/j.ijmm.2026.151742_bib34","unstructured":"Robert Koch-Institute (RKI) (2026). SurvStat. Retrieved 11.05.2026 from https:\/\/survstat.rki.de. Last accessed 07.05.2026."},{"issue":"3","key":"10.1016\/j.ijmm.2026.151742_bib35","first-page":"280","article-title":"Clostridioides difficile infection: an update","volume":"32","author":"Salvati","year":"2024","journal-title":"Infez. Med."},{"issue":"3","key":"10.1016\/j.ijmm.2026.151742_bib36","doi-asserted-by":"crossref","first-page":"316","DOI":"10.3390\/antibiotics14030316","article-title":"Kinetic patterns of antibiotic consumption in german acute care hospitals from 2017 to 2023","volume":"14","author":"Schweickert","year":"2025","journal-title":"Antibiotics"},{"key":"10.1016\/j.ijmm.2026.151742_bib37","doi-asserted-by":"crossref","DOI":"10.1016\/j.anaerobe.2022.102518","article-title":"Clostridioides difficile infection (CDI) during the COVID-19 pandemic","volume":"74","author":"Spigaglia","year":"2022","journal-title":"Anaerobe"},{"issue":"1","key":"10.1016\/j.ijmm.2026.151742_bib38","doi-asserted-by":"crossref","DOI":"10.1080\/22221751.2025.2544733","article-title":"Emerging Clostridioides difficile strains belonging to PCR ribotype 955 in Serbia are distinct from metronidazole-resistant RT955 outbreak isolates from the UK","volume":"14","author":"Stojanovic","year":"2025","journal-title":"Emerg. Microbes Infect."},{"key":"10.1016\/j.ijmm.2026.151742_bib39","doi-asserted-by":"crossref","DOI":"10.3389\/fmicb.2025.1644051","article-title":"Dominance of toxigenic Clostridioides difficile strains and the appearance of the emerging PCR ribotype 955 in hospitals in Silesia, Poland","volume":"16","author":"Szarek","year":"2025","journal-title":"Front. Microbiol."},{"issue":"5","key":"10.1016\/j.ijmm.2026.151742_bib40","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1111\/1469-0691.12619","article-title":"The Clostridium difficile PCR ribotype 027 lineage: a pathogen on the move","volume":"20","author":"Valiente","year":"2014","journal-title":"Clin. Microbiol. Infect."},{"issue":"2","key":"10.1016\/j.ijmm.2026.151742_bib41","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.cmi.2021.09.038","article-title":"European society of clinical microbiology and infectious diseases: 2021 update on the treatment guidance document for Clostridioides difficile infection in adults","volume":"27","author":"van Prehn","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"issue":"5","key":"10.1016\/j.ijmm.2026.151742_bib42","article-title":"Effect of restriction of fluoroquinolone antibiotics on Clostridioides difficile Infections in the University Hospital Hradec Kralove","volume":"10","author":"Vaverkova","year":"2021","journal-title":"Antibiot. (Basel)"},{"issue":"6","key":"10.1016\/j.ijmm.2026.151742_bib43","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1007\/s15010-023-02044-5","article-title":"Trends in the epidemiology of Clostridioides difficile infection in Germany","volume":"51","author":"Vehreschild","year":"2023","journal-title":"Infection"},{"key":"10.1016\/j.ijmm.2026.151742_bib44","article-title":"Comparison of trends in Clostridioides difficile infections in hospitalised patients during the first and second waves of the COVID-19 pandemic: a retrospective sentinel surveillance study","volume":"19","author":"Vendrik","year":"2022","journal-title":"Lancet Reg. Health Eur."},{"issue":"4","key":"10.1016\/j.ijmm.2026.151742_bib45","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1093\/jac\/dky535","article-title":"Effect of fluoroquinolone resistance mutation Thr-82-->Ile on Clostridioides difficile fitness","volume":"74","author":"Vernon","year":"2019","journal-title":"J. Antimicrob. Chemother."},{"issue":"10","key":"10.1016\/j.ijmm.2026.151742_bib46","doi-asserted-by":"crossref","first-page":"2370","DOI":"10.3201\/eid2610.190804","article-title":"Multicenter prevalence study comparing molecular and toxin assays for Clostridioides difficile surveillance, Switzerland","volume":"26","author":"Widmer","year":"2020","journal-title":"Emerg. Infect. Dis."},{"issue":"7","key":"10.1016\/j.ijmm.2026.151742_bib47","doi-asserted-by":"crossref","DOI":"10.3390\/antibiotics12071159","article-title":"Effect of the COVID-19 pandemic on rates and epidemiology of Clostridioides difficile infection in one VA hospital","volume":"12","author":"Wright","year":"2023","journal-title":"Antibiotics"},{"issue":"21","key":"10.1016\/j.ijmm.2026.151742_bib48","doi-asserted-by":"crossref","DOI":"10.2807\/1560-7917.ES.2025.30.21.2400675","article-title":"Newly emerging metronidazole-resistant Clostridioides difficile PCR ribotype 955 identified in Poland, 2021\u20132023 but not in Czechia, 2012\u20132023 and Slovakia, 2015\u20132023","volume":"30","author":"Zikova","year":"2025","journal-title":"Eur. Surveill."}],"container-title":["International Journal of Medical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1438422126000457?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1438422126000457?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T22:03:39Z","timestamp":1794348219000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1438422126000457"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,12]]},"references-count":48,"alternative-id":["S1438422126000457"],"URL":"https:\/\/doi.org\/10.1016\/j.ijmm.2026.151742","relation":{},"ISSN":["1438-4221"],"issn-type":[{"value":"1438-4221","type":"print"}],"subject":[],"published":{"date-parts":[[2026,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Tracking Clostridioides difficile in Germany: Active prospective surveillance progress and molecular epidemiological trends","name":"articletitle","label":"Article Title"},{"value":"International Journal of Medical Microbiology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ijmm.2026.151742","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Author(s). Published by Elsevier GmbH.","name":"copyright","label":"Copyright"}],"article-number":"151742"}}