{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T13:18:19Z","timestamp":1782393499515,"version":"3.54.5"},"reference-count":23,"publisher":"American Society for Microbiology","issue":"11","license":[{"start":{"date-parts":[[2016,11,1]],"date-time":"2016-11-01T00:00:00Z","timestamp":1477958400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100000272","name":"DH | National Institute for Health Research","doi-asserted-by":"publisher","award":["PB-PG-0110-21041"],"award-info":[{"award-number":["PB-PG-0110-21041"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            <jats:named-content content-type=\"genus-species\">Clostridium difficile<\/jats:named-content>\n            (\n            <jats:named-content content-type=\"genus-species\">Peptoclostridium difficile<\/jats:named-content>\n            ) is a common health care-associated infection with a disproportionately high incidence in elderly patients. Disease symptoms range from mild diarrhea to life-threatening pseudomembranous colitis. Around 20% of patients may suffer recurrent disease, which often requires rehospitalization of patients.\n            <jats:named-content content-type=\"genus-species\">C. difficile<\/jats:named-content>\n            was isolated from stool samples from a patient with two recurrent\n            <jats:named-content content-type=\"genus-species\">C. difficile<\/jats:named-content>\n            infections. PCR ribotyping, whole-genome sequencing, and phenotypic assays were used to characterize these isolates. Genotypic and phenotypic screening of\n            <jats:named-content content-type=\"genus-species\">C. difficile<\/jats:named-content>\n            isolates revealed multiple PCR ribotypes present and the emergence of rifamycin resistance during the infection cycle. Understanding both the clinical and bacterial factors that contribute to the course of recurrent infection could inform strategies to reduce recurrence. (This study has been registered at ClinicalTrials.gov under registration no. NCT01670149.)\n          <\/jats:p>","DOI":"10.1128\/jcm.01025-16","type":"journal-article","created":{"date-parts":[[2016,8,25]],"date-time":"2016-08-25T02:49:12Z","timestamp":1472093352000},"page":"2689-2694","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":9,"title":["Coinfection and Emergence of Rifamycin Resistance during a Recurrent Clostridium difficile Infection"],"prefix":"10.1128","volume":"54","author":[{"given":"Emma C.","family":"Stevenson","sequence":"first","affiliation":[{"name":"Clostridia Research Group, BBSRC\/EPSRC Synthetic Biology Research Centre (SBRC), School of Life Sciences, University of Nottingham, Nottingham, United Kingdom"},{"name":"NIHR Biomedical Research Unit in Gastrointestinal and Liver Diseases at Nottingham University Hospitals NHS Trust and The University of Nottingham, Nottingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giles A.","family":"Major","sequence":"additional","affiliation":[{"name":"Queen's Medical Centre, Nottingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin C.","family":"Spiller","sequence":"additional","affiliation":[{"name":"Queen's Medical Centre, Nottingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah A.","family":"Kuehne","sequence":"additional","affiliation":[{"name":"Clostridia Research Group, BBSRC\/EPSRC Synthetic Biology Research Centre (SBRC), School of Life Sciences, University of Nottingham, Nottingham, United Kingdom"},{"name":"NIHR Biomedical Research Unit in Gastrointestinal and Liver Diseases at Nottingham University Hospitals NHS Trust and The University of Nottingham, Nottingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel P.","family":"Minton","sequence":"additional","affiliation":[{"name":"Clostridia Research Group, BBSRC\/EPSRC Synthetic Biology Research Centre (SBRC), School of Life Sciences, University of Nottingham, Nottingham, United Kingdom"},{"name":"NIHR Biomedical Research Unit in Gastrointestinal and Liver Diseases at Nottingham University Hospitals NHS Trust and The University of Nottingham, Nottingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2009.03.010"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2008.12.038"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2009.10.016"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1086\/592981"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis790"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anaerobe.2014.07.003"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00342-08"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1086\/596315"},{"key":"e_1_3_3_10_2","volume-title":"Molecular cloning: a laboratory manual","author":"Sambrook J","year":"2001","unstructured":"Sambrook J, Russell DW. 2001. 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