{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:56:25Z","timestamp":1787313385508,"version":"build-2736575974"},"reference-count":47,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002865","name":"Chongqing Science and Technology Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Global Antimicrobial Resistance"],"published-print":{"date-parts":[[2024,9]]},"DOI":"10.1016\/j.jgar.2024.07.006","type":"journal-article","created":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T13:08:01Z","timestamp":1721653681000},"page":"198-204","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":10,"special_numbering":"C","title":["Antimicrobial susceptibilities, resistance mechanisms and molecular characteristics of toxigenic Clostridioides difficile isolates in a large teaching hospital in Chongqing, China"],"prefix":"10.1016","volume":"38","author":[{"given":"Zijun","family":"Dang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bingxue","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peiwen","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinzhu","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiajia","family":"Liao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqiong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiyu","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengli","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jgar.2024.07.006_bib0001","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1007\/s10096-019-03539-6","article-title":"Clostridium difficile infection: review","volume":"38","author":"Czepiel","year":"2019","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"10.1016\/j.jgar.2024.07.006_bib0002","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1128\/CMR.00021-17","article-title":"Understanding Clostridium difficile colonization","volume":"31","author":"Crobach","year":"2018","journal-title":"Clin Microbiol Rev"},{"key":"10.1016\/j.jgar.2024.07.006_bib0003","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1038\/s41579-021-00660-2","article-title":"Clostridioides difficile toxins: mechanisms of action and antitoxin therapeutics","volume":"20","author":"Kordus","year":"2022","journal-title":"Nat Rev Microbiol"},{"key":"10.1016\/j.jgar.2024.07.006_bib0004","doi-asserted-by":"crossref","DOI":"10.1016\/j.micres.2022.127113","article-title":"Host and microbial-derived metabolites for Clostridioides difficile infection: contributions, mechanisms and potential applications","volume":"263","author":"Gao","year":"2022","journal-title":"Microbiol Res"},{"key":"10.1016\/j.jgar.2024.07.006_bib0005","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.mib.2022.01.004","article-title":"Mechanisms and impact of antimicrobial resistance in Clostridioides difficile","volume":"66","author":"Dureja","year":"2022","journal-title":"Curr Opin Microbiol"},{"key":"10.1016\/j.jgar.2024.07.006_bib0006","doi-asserted-by":"crossref","first-page":"96","DOI":"10.3389\/fmed.2018.00096","article-title":"Novel Antimicrobials for the treatment of Clostridium difficile Infection","volume":"5","author":"Petrosillo","year":"2018","journal-title":"Front Med (Lausanne)"},{"key":"10.1016\/j.jgar.2024.07.006_bib0007","doi-asserted-by":"crossref","first-page":"3077","DOI":"10.1093\/jac\/dkab231","article-title":"Mechanisms of antibiotic resistance of Clostridioides difficile","volume":"76","author":"Wickramage","year":"2021","journal-title":"J Antimicrob Chemother"},{"key":"10.1016\/j.jgar.2024.07.006_bib0008","first-page":"941","article-title":"Plasmid acquisition alters vancomycin susceptibility in Clostridioides difficile","volume":"160","author":"Pu","year":"2021","journal-title":"Gastroenterology (New York, N.Y. 1943)"},{"issue":"1","key":"10.1016\/j.jgar.2024.07.006_bib0009","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1038\/s41467-020-14382-1","article-title":"Plasmid-mediated metronidazole resistance in Clostridioides difficile","volume":"11","author":"Boekhoud","year":"2020","journal-title":"Nature Commun"},{"key":"10.1016\/j.jgar.2024.07.006_bib0010","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1007\/s10096-020-04121-1","article-title":"Tigecycline antibacterial activity, clinical effectiveness, and mechanisms and epidemiology of resistance: narrative review","volume":"41","author":"Yaghoubi","year":"2022","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"10.1016\/j.jgar.2024.07.006_bib0011","doi-asserted-by":"crossref","first-page":"171","DOI":"10.2147\/IDR.S238916","article-title":"High-level resistance of toxigenic Clostridioides difficile genotype to Macrolide-Lincosamide- Streptogramin B in community acquired patients in eastern China","volume":"13","author":"Zhao","year":"2020","journal-title":"Infect Drug Resist"},{"key":"10.1016\/j.jgar.2024.07.006_bib0012","doi-asserted-by":"crossref","first-page":"2459","DOI":"10.1007\/s10096-021-04311-5","article-title":"Antimicrobial resistance in Clostridioides difficile","volume":"40","author":"O\u2019Grady","year":"2021","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"10.1016\/j.jgar.2024.07.006_bib0013","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1186\/s12879-020-05014-6","article-title":"Characteristics of Clostridium difficile isolates and the burden of hospital-acquired Clostridium difficile infection in a tertiary teaching hospital in Chongqing, Southwest China","volume":"20","author":"Dai","year":"2020","journal-title":"BMC Infect Dis"},{"key":"10.1016\/j.jgar.2024.07.006_bib0014","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/1476-0711-13-21","article-title":"Study of the frequency of Clostridium difficile tcdA, tcdB, cdtA and cdtB genes in feces of Calves in south west of Iran","volume":"13","author":"Doosti","year":"2014","journal-title":"Ann Clin Microbiol Antimicrob"},{"key":"10.1016\/j.jgar.2024.07.006_bib0015","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1111\/j.1574-6968.1999.tb13620.x","article-title":"Deletions in the repeating sequences of the toxin A gene of toxin A-negative, toxin B-positive Clostridium difficile strains","volume":"175","author":"Kato","year":"1999","journal-title":"FEMS Microbiol Lett"},{"key":"10.1016\/j.jgar.2024.07.006_bib0016","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1128\/JCM.01796-09","article-title":"Multilocus Sequence Typing of Clostridium difficile","volume":"48","author":"Griffiths","year":"2010","journal-title":"J Clin Microbiol"},{"key":"10.1016\/j.jgar.2024.07.006_bib0017","doi-asserted-by":"crossref","first-page":"578098","DOI":"10.3389\/fcimb.2020.578098","article-title":"Molecular epidemiology and risk factors of Clostridium difficile ST81 infection in a teaching hospital in Eastern China","volume":"10","author":"Yang","year":"2020","journal-title":"Front Cell Infect Microbiol"},{"key":"10.1016\/j.jgar.2024.07.006_bib0018","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.ijantimicag.2008.09.022","article-title":"Clostridium difficile infections in a Shanghai hospital: antimicrobial resistance, toxin profiles and ribotypes","volume":"33","author":"Huang","year":"2009","journal-title":"Int J Antimicrobial Agents"},{"key":"10.1016\/j.jgar.2024.07.006_bib0019","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1093\/jac\/dkl398","article-title":"High-level resistance to moxifloxacin and gatifloxacin associated with a novel mutation in gyrB in toxin-A-negative, toxin-B-positive Clostridium difficile","volume":"58","author":"Drudy","year":"2006","journal-title":"J Antimicrob Chemother"},{"key":"10.1016\/j.jgar.2024.07.006_bib0020","doi-asserted-by":"crossref","first-page":"16","DOI":"10.5009\/gnl18071","article-title":"Recurrent Clostridium difficile infection: risk factors, treatment, and prevention","volume":"13","author":"Song","year":"2019","journal-title":"Gut Liver"},{"key":"10.1016\/j.jgar.2024.07.006_bib0021","doi-asserted-by":"crossref","first-page":"489","DOI":"10.2147\/IDR.S152724","article-title":"Molecular epidemiology of Clostridium difficile in two tertiary care hospitals in Shandong Province, China","volume":"11","author":"Luo","year":"2018","journal-title":"Infect Drug Resist"},{"key":"10.1016\/j.jgar.2024.07.006_bib0022","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.jgar.2022.06.017","article-title":"Molecular characterization and antibiotic resistance of Clostridioides difficile in patients with inflammatory bowel disease from two hospitals in China","volume":"30","author":"Lv","year":"2022","journal-title":"J Glob Antimicrob Resist"},{"key":"10.1016\/j.jgar.2024.07.006_bib0023","doi-asserted-by":"crossref","first-page":"3379","DOI":"10.2147\/IDR.S407497","article-title":"Genomic epidemiology and antimicrobial resistance profiles of Clostridioides difficile from multi-hospitals in a city in eastern China","volume":"16","author":"Shu","year":"2023","journal-title":"Infect Drug Resist"},{"key":"10.1016\/j.jgar.2024.07.006_bib0024","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.ijid.2023.03.009","article-title":"Prevalence and molecular characterization of Clostridioides difficile infection in China over the past 5 years: a systematic review and meta-analysis","volume":"130","author":"Wen","year":"2023","journal-title":"Int J Infect Dis"},{"key":"10.1016\/j.jgar.2024.07.006_bib0025","doi-asserted-by":"crossref","first-page":"102540","DOI":"10.1016\/j.anaerobe.2022.102540","article-title":"A narrative review of Clostridioides difficile infection in China","volume":"74","author":"Wu","year":"2022","journal-title":"Anaerobe"},{"issue":"15","key":"10.1016\/j.jgar.2024.07.006_bib0026","doi-asserted-by":"crossref","first-page":"2100417","DOI":"10.2807\/1560-7917.ES.2022.27.15.2100417","article-title":"Clostridioides difficile positivity rate and PCR ribotype distribution on retail potatoes in 12 European countries, January to June 2018","volume":"27","author":"Tkalec","year":"2022","journal-title":"Euro Surveill"},{"key":"10.1016\/j.jgar.2024.07.006_bib0027","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1016\/j.cmi.2019.10.023","article-title":"Clostridium difficile and One Health","volume":"26","author":"Lim","year":"2020","journal-title":"Clin Microbiol Infect"},{"key":"10.1016\/j.jgar.2024.07.006_bib0028","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1080\/22221751.2019.1621670","article-title":"Clostridium difficile ribotype 017 - characterization, evolution and epidemiology of the dominant strain in Asia","volume":"8","author":"Imwattana","year":"2019","journal-title":"Emerg Microbes Infect"},{"key":"10.1016\/j.jgar.2024.07.006_bib0029","doi-asserted-by":"crossref","first-page":"105981","DOI":"10.1016\/j.ijantimicag.2020.105981","article-title":"The tcdA-negative and tcdB-positive Clostridium difficile ST81 clone exhibits a high level of resistance to fluoroquinolones: a multi-centre study in Beijing, China","volume":"56","author":"Cheng","year":"2020","journal-title":"Int J Antimicrobial Agents"},{"key":"10.1016\/j.jgar.2024.07.006_bib0030","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1038\/ng.2478","article-title":"Emergence and global spread of epidemic healthcare-associated Clostridium difficile","volume":"45","author":"He","year":"2013","journal-title":"Nat Genet"},{"key":"10.1016\/j.jgar.2024.07.006_bib0031","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1186\/s13756-020-00815-5","article-title":"Antimicrobial resistance in Clostridioides (Clostridium) difficile derived from humans: a systematic review and meta-analysis","volume":"9","author":"Sholeh","year":"2020","journal-title":"Antimicrob Resist Infect Control"},{"key":"10.1016\/j.jgar.2024.07.006_bib0032","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijantimicag.2022.106570","article-title":"Metronidazole-resistant Clostridioides difficile: genomic and transcriptomic traits acquired under in-vitro metronidazole induction","volume":"59","author":"Xu","year":"2022","journal-title":"Int J Antimicrob Agents"},{"key":"10.1016\/j.jgar.2024.07.006_bib0033","doi-asserted-by":"crossref","first-page":"102094","DOI":"10.1016\/j.anaerobe.2019.102094","article-title":"Antibiotic resistance of clinical isolates of Clostridioides difficile in China and its association with geographical regions and patient age","volume":"60","author":"Li","year":"2019","journal-title":"Anaerobe"},{"key":"10.1016\/j.jgar.2024.07.006_bib0034","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/j.ajic.2017.08.020","article-title":"Epidemiology and risk factors for Clostridium difficile-associated diarrhea in adult inpatients in a university hospital in China","volume":"46","author":"Tang","year":"2018","journal-title":"Am J Infect Control"},{"key":"10.1016\/j.jgar.2024.07.006_bib0035","article-title":"Penicillin binding protein substitutions cooccur with fluoroquinolone resistance in epidemic lineages of multidrug-resistant Clostridioides difficile","volume":"14","year":"2023","journal-title":"mBio"},{"key":"10.1016\/j.jgar.2024.07.006_bib0036","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"},{"key":"10.1016\/j.jgar.2024.07.006_bib0037","doi-asserted-by":"crossref","first-page":"5604","DOI":"10.1128\/AAC.01137-16","article-title":"Rifamycin resistance in Clostridium difficile is generally associated with a low fitness burden","volume":"60","author":"Dang","year":"2016","journal-title":"Antimicrob Agents Chemother"},{"issue":"2","key":"10.1016\/j.jgar.2024.07.006_bib0038","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1128\/mBio.02790-18","article-title":"A role for tetracycline selection in recent evolution of agriculture-associated Clostridium difficile PCR Ribotype 078","volume":"10","author":"Dingle","year":"2019","journal-title":"mBio"},{"key":"10.1016\/j.jgar.2024.07.006_bib0039","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1007\/s10096-019-03756-z","article-title":"Tigecycline for the treatment of patients with Clostridium difficile infection: an update of the clinical evidence","volume":"39","author":"Kechagias","year":"2020","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"10.1016\/j.jgar.2024.07.006_bib0040","doi-asserted-by":"crossref","first-page":"37865","DOI":"10.1038\/srep37865","article-title":"The incidence and drug resistance of Clostridium difficile infection in Mainland China: a systematic review and meta-analysis","volume":"6","author":"Tang","year":"2016","journal-title":"Sci Rep"},{"key":"10.1016\/j.jgar.2024.07.006_bib0041","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.jgar.2017.04.005","article-title":"Antimicrobial susceptibility of Clostridium difficile isolates in Israel","volume":"10","author":"Tkhawkho","year":"2017","journal-title":"J Global Antimicrob Resist"},{"key":"10.1016\/j.jgar.2024.07.006_bib0042","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1093\/jac\/dkv420","article-title":"Tigecycline resistance in clinical isolates of Enterococcus faecium is mediated by an upregulation of plasmid-encoded tetracycline determinants tet(L) and tet(M)","volume":"71","author":"Fiedler","year":"2016","journal-title":"J Antimicrob Chemother"},{"key":"10.1016\/j.jgar.2024.07.006_bib0043","doi-asserted-by":"crossref","DOI":"10.1128\/Spectrum.01310-21","article-title":"Novel Tet(L) efflux pump variants conferring resistance to Tigecycline and Eravacycline in Staphylococcus Spp","volume":"9","author":"Wang","year":"2021","journal-title":"Microbiol. Spectr."},{"key":"10.1016\/j.jgar.2024.07.006_bib0044","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1111\/j.1365-2958.1994.tb00320.x","article-title":"The Clostridium perfringens Tet P determinant comprises two overlapping genes: tetA(P), which mediates active tetracycline efflux, and tetB(P), which is related to the ribosomal protection family of tetracycline-resistance determinants","volume":"11","author":"Sloan","year":"1994","journal-title":"Mol Microbiol"},{"key":"10.1016\/j.jgar.2024.07.006_bib0045","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1093\/jac\/dkab056","article-title":"Phenotypic and genetic barriers to establishment of horizontally transferred genes encoding ribosomal protection proteins","volume":"76","author":"Yadav","year":"2021","journal-title":"J Antimicrob Chemother"},{"key":"10.1016\/j.jgar.2024.07.006_bib0046","doi-asserted-by":"crossref","first-page":"2138","DOI":"10.3389\/fmicb.2016.02138","article-title":"Genome analysis of Clostridium difficile PCR Ribotype 014 lineage in australian pigs and humans reveals a diverse genetic repertoire and signatures of long-range interspecies transmission","volume":"7","author":"Knight","year":"2017","journal-title":"Front. Microbiol."},{"key":"10.1016\/j.jgar.2024.07.006_bib0047","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.anaerobe.2019.01.005","article-title":"Clostridium difficile isolates derived from Czech horses are resistant to enrofloxacin; cluster to clades 1 and 5 and ribotype 033 predominates","volume":"56","author":"Kecerova","year":"2019","journal-title":"Anaerobe"}],"container-title":["Journal of Global Antimicrobial Resistance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2213716524001383?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2213716524001383?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2024,9,15]],"date-time":"2024-09-15T05:42:59Z","timestamp":1726378979000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2213716524001383"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9]]},"references-count":47,"alternative-id":["S2213716524001383"],"URL":"https:\/\/doi.org\/10.1016\/j.jgar.2024.07.006","relation":{},"ISSN":["2213-7165"],"issn-type":[{"value":"2213-7165","type":"print"}],"subject":[],"published":{"date-parts":[[2024,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Antimicrobial susceptibilities, resistance mechanisms and molecular characteristics of toxigenic Clostridioides difficile isolates in a large teaching hospital in Chongqing, China","name":"articletitle","label":"Article Title"},{"value":"Journal of Global Antimicrobial Resistance","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jgar.2024.07.006","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2024 The Author(s). Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy.","name":"copyright","label":"Copyright"}]}}