{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T02:04:59Z","timestamp":1787882699581,"version":"build-2784847793"},"reference-count":81,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T00:00:00Z","timestamp":1646870400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:p><jats:italic>Clostridioides difficile<\/jats:italic> is a global public health problem, which is a primary cause of antibiotic-associated diarrhea in humans. The emergence of hypervirulent and antibiotic-resistant strains is associated with the increased incidence and severity of the disease. There are limited studies on genomic characterization of <jats:italic>C. difficile<\/jats:italic> in Latin America. We aimed to learn about the molecular epidemiology and antimicrobial resistance in <jats:italic>C. difficile<\/jats:italic> strains from adults and children in hospitals of M\u00e9xico. We studied 94 <jats:italic>C. difficile<\/jats:italic> isolates from seven hospitals in Mexico City from 2014 to 2018. Whole-genome sequencing (WGS) was used to determine the genotype and examine the toxigenic profiles. Susceptibility to antibiotics was determined by <jats:italic>E<\/jats:italic>-test. Multilocus sequence typing (MLST) was used to determine allelic profiles. Results identified 20 different sequence types (ST) in the 94 isolates, mostly clade 2 and clade 1. ST1 was predominant in isolates from adult and children. Toxigenic strains comprised 87.2% of the isolates that were combinations of <jats:italic>tcdAB<\/jats:italic> and <jats:italic>cdtAB<\/jats:italic> (<jats:italic>tcdA+\/tcdB+\/cdtA+\/cdtB+<\/jats:italic>, followed by <jats:italic>tcdA+\/tcdB+\/cdtA\u2212\/cdtB\u2212<\/jats:italic>, <jats:italic>tcdA<\/jats:italic>\u2212\/<jats:italic>tcdB+\/cdtA\u2212\/ cdtB\u2212<\/jats:italic>, and <jats:italic>tcdA\u2212<\/jats:italic>\/<jats:italic>tcdB\u2212\/cdtA+\/cdtB+<\/jats:italic>). Toxin profiles were more diverse in isolates from children. All 94 isolates were susceptible to metronidazole and vancomycin, whereas a considerable number of isolates were resistant to clindamycin, fluroquinolones, rifampicin, meropenem, and linezolid. Multidrug-resistant isolates (\u22653 antibiotics) comprised 65% of the isolates. The correlation between resistant genotypes and phenotypes was evaluated by the kappa test. Mutations in <jats:italic>rpoB<\/jats:italic> and <jats:italic>rpoC<\/jats:italic> showed moderate concordance with resistance to rifampicin and mutations in <jats:italic>fusA<\/jats:italic> substantial concordance with fusidic acid resistance. <jats:italic>cfrE<\/jats:italic>, a gene recently described in one Mexican isolate, was present in 65% of strains linezolid resistant, all ST1 organisms. WGS is a powerful tool to genotype and characterize virulence and antibiotic susceptibility patterns.<\/jats:p>","DOI":"10.3389\/fmicb.2021.787451","type":"journal-article","created":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T09:10:09Z","timestamp":1646903409000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":26,"title":["Molecular Epidemiology and Antimicrobial Resistance of Clostridioides difficile in Hospitalized Patients From Mexico"],"prefix":"10.3389","volume":"12","author":[{"given":"Emmanuel","family":"Aguilar-Zamora","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart C.","family":"Weimer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto C.","family":"Torres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"G\u00f3mez-Delgado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nayeli","family":"Ortiz-Olvera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerardo","family":"Aparicio-Ozores","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varenka J.","family":"Barbero-Becerra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Torres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarita","family":"Camorlinga-Ponce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,3,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1093\/jac\/dkg112","article-title":"Prevalence and association of macrolide-lincosamide-streptogramin B (MLSB) resistance with resistance to moxifloxacin in Clostridium difficile.","volume":"51","author":"Ackermann","year":"2003","journal-title":"J. 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