{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T01:37:48Z","timestamp":1772847468458,"version":"3.50.1"},"reference-count":40,"publisher":"American Society for Microbiology","issue":"7","license":[{"start":{"date-parts":[[2012,7,1]],"date-time":"2012-07-01T00:00:00Z","timestamp":1341100800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2012,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            A total of 403 nonduplicate isolates of\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Clostridium difficile<\/jats:named-content>\n            were collected at three major teaching hospitals representing northern, central, and southern Taiwan from January 2005 to December 2010. Of these 403 isolates, 170 (42.2%) were presumed to be nontoxigenic due to the absence of genes for toxins A or B or binary toxin. The remaining 233 (57.8%) isolates carried toxin A and B genes, and 39 (16.7%) of these also had binary toxin genes. The MIC\n            <jats:sub>90<\/jats:sub>\n            of all isolates for fidaxomicin and rifaximin was 0.5 \u03bcg\/ml (range, \u22640.015 to 0.5 \u03bcg\/ml) and &gt;128 \u03bcg\/ml (range, \u22640.015 to &gt;128 \u03bcg\/ml), respectively. All isolates were susceptible to metronidazole (MIC\n            <jats:sub>90<\/jats:sub>\n            of 0.5 \u03bcg\/ml; range, \u22640.03 to 4 \u03bcg\/ml). Two isolates had reduced susceptibility to vancomycin (MICs, 4 \u03bcg\/ml). Only 13.6% of isolates were susceptible to clindamycin (MIC of \u22642 \u03bcg\/ml). Nonsusceptibility to moxifloxacin (\n            <jats:italic>n<\/jats:italic>\n            = 81, 20.1%) was accompanied by single or multiple mutations in\n            <jats:italic>gyrA<\/jats:italic>\n            and\n            <jats:italic>gyrB<\/jats:italic>\n            genes in all but eight moxifloxacin-nonsusceptible isolates. Two previously unreported\n            <jats:italic>gyrB<\/jats:italic>\n            mutations might independently confer resistance (MIC, 16 \u03bcg\/ml), Ser416 to Ala and Glu466 to Lys. Moxifloxacin-resistant isolates were cross-resistant to ciprofloxacin and levofloxacin, but some moxifloxacin-nonsusceptible isolates remained susceptible to gemifloxacin or nemonoxacin at 0.5 \u03bcg\/ml. This study found the diversity of toxigenic and nontoxigenic strains of\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">C. difficile<\/jats:named-content>\n            in the health care setting in Taiwan. All isolates tested were susceptible to metronidazole and vancomycin. Fidaxomicin exhibited potent\n            <jats:italic>in vitro<\/jats:italic>\n            activity against all isolates tested, while the more than 10% of Taiwanese isolates with rifaximin MICs of \u2265128 \u03bcg\/ml raises concerns.\n          <\/jats:p>","DOI":"10.1128\/aac.00191-12","type":"journal-article","created":{"date-parts":[[2012,4,17]],"date-time":"2012-04-17T05:22:29Z","timestamp":1334640149000},"page":"3943-3949","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":47,"title":["Characterizations of Clinical Isolates of Clostridium difficile by Toxin Genotypes and by Susceptibility to 12 Antimicrobial Agents, Including Fidaxomicin (OPT-80) and Rifaximin: a Multicenter Study in Taiwan"],"prefix":"10.1128","volume":"56","author":[{"given":"Chun-Hsing","family":"Liao","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-Chien","family":"Ko","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Center for Infection Control, National Cheng Kung University Hospital and Medical College, Tainan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jang-Jih","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Chang Gung Memorial Hospital, Chang Gung University Medical College, Lin-Ko, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Po-Ren","family":"Hsueh","sequence":"additional","affiliation":[{"name":"Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.45.8.2348-2353.2001"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00090-08"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkn313"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2009.03099.x"},{"key":"e_1_3_2_6_2","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/S1684-1182(10)60019-9","article-title":"Clostridium difficile infection at a medical center in southern Taiwan: incidence, clinical features and prognosis","volume":"43","author":"Chung CH","year":"2010","unstructured":"ChungCH . 2010. 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