{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:32:53Z","timestamp":1777923173023,"version":"3.51.4"},"reference-count":52,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T00:00:00Z","timestamp":1635724800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2021,11,1]]},"abstract":"<jats:p>\n                    Antimicrobial resistance (AMR) plays an important role in the pathogenesis and spread of\n                    <jats:italic toggle=\"yes\">Clostridioides difficile<\/jats:italic>\n                    infection (CDI). Many antimicrobials, such as fluoroquinolones, have been associated with outbreaks of CDI globally. This study characterized AMR among clinical\n                    <jats:italic toggle=\"yes\">C. difficile<\/jats:italic>\n                    strains in Thailand, where antimicrobial use remains inadequately regulated. Stool samples were screened for\n                    <jats:italic toggle=\"yes\">tcdB<\/jats:italic>\n                    and positives were cultured\n                    <jats:italic toggle=\"yes\">. C. difficile<\/jats:italic>\n                    isolates were characterized by toxin profiling and PCR ribotyping. Antimicrobial susceptibility testing was performed by agar incorporation, and whole-genome sequencing and AMR genotyping were performed on a subset of strains. There were 321\n                    <jats:italic toggle=\"yes\">C. difficile<\/jats:italic>\n                    strains isolated from 326 stool samples. The most common toxigenic ribotype (RT) was RT 017 (18%), followed by RTs 014 (12%) and 020 (7%). Resistance to clindamycin, erythromycin, moxifloxacin, and rifaximin was common, especially among RT 017 strains. AMR genotyping revealed a strong correlation between resistance genotype and phenotype for moxifloxacin and rifaximin. The presence of\n                    <jats:italic toggle=\"yes\">erm<\/jats:italic>\n                    -class genes was associated with high-level clindamycin and erythromycin resistance. Point substitutions in the penicillin-binding proteins were not sufficient to confer meropenem resistance, but a Y721S substitution in PBP3 was associated with a 4.37-fold increase in meropenem minimal inhibitory concentration. No resistance to metronidazole, vancomycin, or fidaxomicin was observed.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2020.0603","type":"journal-article","created":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T15:33:03Z","timestamp":1620315183000},"page":"1505-1512","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":20,"title":["Molecular Characterization of, and Antimicrobial Resistance in,\n                    <i>Clostridioides difficile<\/i>\n                    from Thailand, 2017\u20132018"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2538-9775","authenticated-orcid":false,"given":"Korakrit","family":"Imwattana","sequence":"first","affiliation":[{"name":"School of Biomedical Sciences, The University of Western Australia, Nedlands, Australia."},{"name":"Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Papanin","family":"Putsathit","sequence":"additional","affiliation":[{"name":"School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel R.","family":"Knight","sequence":"additional","affiliation":[{"name":"School of Biomedical Sciences, The University of Western Australia, Nedlands, Australia."},{"name":"Medical, Molecular and Forensic Sciences, Murdoch University, Murdoch, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pattarachai","family":"Kiratisin","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas V.","family":"Riley","sequence":"additional","affiliation":[{"name":"School of Biomedical Sciences, The University of Western Australia, Nedlands, Australia."},{"name":"School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia."},{"name":"Medical, Molecular and Forensic Sciences, Murdoch University, Murdoch, Australia."},{"name":"Department of Microbiology, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Nedlands, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,11,11]]},"reference":[{"key":"e_1_3_5_2_2","first-page":"287","article-title":"Clostridium difficile infection","volume":"373","author":"Leffler D.A.","year":"2015","unstructured":"Leffler D.A., , and Lamont J.T.. 2015. 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