{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:18:33Z","timestamp":1790983113630,"version":"4.1.0"},"reference-count":12,"publisher":"American Society for Microbiology","issue":"9","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01AI139261"],"award-info":[{"award-number":["R01AI139261"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2026,9,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Clostridioides difficile<\/jats:italic>\n                      infection (CDI) has limited antibiotic treatment options, with fidaxomicin being the guideline-preferred antibiotic. C. E. Kaple, S. N. Redmond, J. L. Cadum, B. Hausman, et al. (Antimicrob Agents Chemother 0:e00130-26, 2026,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/doi.org\/10.1128\/aac.00130-26\" xlink:type=\"simple\">https:\/\/doi.org\/10.1128\/aac.00130-26<\/jats:ext-link>\n                      ) describe a case of clinical failure in an elderly patient with CDI treated with a pulsed-taper fidaxomicin regimen, in which the MIC increased from 0.05 \u03bcg\/mL at baseline to 32 \u03bcg\/mL in isolates recovered during relapse. Relapsing symptoms were eventually resolved only after switching to oral vancomycin. This case, together with other recent clinical reports, may be the tip of the iceberg, signaling that fidaxomicin-resistant\n                      <jats:italic toggle=\"yes\">C. difficile<\/jats:italic>\n                      can arise during treatment and contribute to clinical failure. It further challenges the assumption that high colonic drug concentrations mitigate resistance and underscores the need for improved surveillance and the development of clinically applicable molecular diagnostics to detect fidaxomicin resistance in CDI patient samples.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.00482-26","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T13:25:35Z","timestamp":1785763535000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":1,"title":["Case Commentary: Emergence of clinically relevant fidaxomicin-resistant\n                    <i>Clostridioides difficile<\/i>\n                    strains"],"prefix":"10.1128","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2063-7503","authenticated-orcid":true,"given":"Kevin W.","family":"Garey","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/048sx0r50","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy","place":["Houston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2214-8105","authenticated-orcid":true,"given":"Julian G.","family":"Hurdle","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01f5ytq51","id-type":"ROR","asserted-by":"publisher"}],"name":"Center for Infectious and Inflammatory Diseases, Institute of Biosciences and Technology","place":["Houston, USA"]},{"id":[{"id":"https:\/\/ror.org\/01f5ytq51","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Translational Medical Sciences, Naresh K. Vashisht College of Medicine, Texas A&M University","place":["Houston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/aac.00130-26"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01259-19"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkad194"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaf028"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-022-04545-z"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/aac.01206-24"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/2915018"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01831-10"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkx486"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-024-08095-4"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis339"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00104-11"}],"container-title":["Antimicrobial Agents and Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/aac.00482-26","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/aac.00482-26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T16:55:03Z","timestamp":1788368103000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/aac.00482-26"}},"subtitle":[],"editor":[{"given":"Cesar A.","family":"Arias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,9,2]]},"references-count":12,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9,2]]}},"alternative-id":["10.1128\/aac.00482-26"],"URL":"https:\/\/doi.org\/10.1128\/aac.00482-26","relation":{},"ISSN":["0066-4804","1098-6596"],"issn-type":[{"value":"0066-4804","type":"print"},{"value":"1098-6596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,2]]},"assertion":[{"value":"2026-08-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e00482-26"}}