{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T17:11:20Z","timestamp":1770225080974,"version":"3.49.0"},"reference-count":43,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI20\/01450"],"award-info":[{"award-number":["PI20\/01450"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008425","name":"Department of Education, Culture, Universities, and Employment of the Valencian Community","doi-asserted-by":"publisher","award":["CIAICO 2023\/274"],"award-info":[{"award-number":["CIAICO 2023\/274"]}],"id":[{"id":"10.13039\/501100008425","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017642","name":"PTA","doi-asserted-by":"publisher","award":["PTA2021-020215-I"],"award-info":[{"award-number":["PTA2021-020215-I"]}],"id":[{"id":"10.13039\/501100017642","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ministerio de Ciencia e Innovaci\u00f3n\/Agencia Estatal de Investigaci\u00f3n"},{"DOI":"10.13039\/501100004895","name":"European Social Fund","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004895","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100031566","name":"ISABIAL","doi-asserted-by":"crossref","award":["2024\/B\/29"],"award-info":[{"award-number":["2024\/B\/29"]}],"id":[{"id":"10.13039\/100031566","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background\/Objetives: The objective of this study was to determine the in vitro susceptibility profiles of clinical Clostridioides difficile isolates to metronidazole (MTZ), vancomycin (VAN), fidaxomicin (FDX), tigecycline (TGC), and eravacycline (ERV) in a multicenter Spanish cohort, and to evaluate their association with clinical factors. Methods: Strains were obtained from prospectively included patients in the ICD-ANCRAID-SEICV cohort (ClinicalTrials.gov ID: NCT04801862) in Andaluc\u00eda and the Valencian Community between 1 January 2020 and 30 April 2023. Antimicrobial susceptibility testing was performed using E-test for MTZ, VAN, TGC, and ERV, and agar dilution for FDX. Results: The results were interpreted following EUCAST clinical breakpoints and ECOFF criteria. A total of 107 patients were included (median age 70 years; 65.4% women). Nearly half of the cases were community-acquired, 30% nosocomial, and the remainder healthcare-associated. Most infections were non-severe, and 32.7% experienced recurrence. Overall resistance levels were low: VAN and TGC each showed resistance in 2.8% of isolates, followed by MTZ (1.9%). Only one isolate was resistant to FDX (0.9%), and none to ERV. MIC90 values were low for all agents. Some resistant isolates displayed co-resistance and were recovered from patients with prior antibiotic exposure. Among the seven patients carrying resistant strains, most were women, and the cases were predominantly community-acquired. Clinical characteristics, including age, comorbidity, infection origin, and severity, did not differ from those with susceptible isolates. All patients achieved clinical cure without recurrent infection. No association was found between elevated MIC values and recurrence or greater severity. Conclusions: FDX and ERV demonstrated excellent in vitro activity. Resistance to MTZ, VAN, and TGC was uncommon but detectable. Findings highlight the need for continued antimicrobial resistance surveillance and evaluation of its potential clinical impact.<\/jats:p>","DOI":"10.3390\/antibiotics15020145","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T09:00:33Z","timestamp":1770022833000},"page":"145","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Antimicrobial Susceptibility of Clostridioides difficile in Spain: Multicenter Retrospective Cohort Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1979-0949","authenticated-orcid":false,"given":"Mar\u00eda-Paz","family":"Ventero","sequence":"first","affiliation":[{"name":"Microbiology Service, Alicante General University Hospital, Alicante Institute of Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7079-6634","authenticated-orcid":false,"given":"Mar\u00eda-Dolores","family":"Valverde-Fredet","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Microbiology Clinical Unit, Valme University Hospital, Institute of Biomedicine of Seville (IBiS), University of Seville, 41004 Sevilla, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esperanza","family":"Merino","sequence":"additional","affiliation":[{"name":"Clinical Medicine Department, Miguel Hern\u00e1ndez University, 03202 Elche, Spain"},{"name":"Infectious Diseases Unit, Alicante General University Hospital, Alicante Institute of Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roc\u00edo","family":"Herrero","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Microbiology Clinical Unit, Valme University Hospital, Institute of Biomedicine of Seville (IBiS), University of Seville, 41004 Sevilla, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iryna Tyschkovska","family":"Germak","sequence":"additional","affiliation":[{"name":"Microbiology Service, Alicante General University Hospital, Alicante Institute of Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8028-3722","authenticated-orcid":false,"given":"Miguel","family":"Rodr\u00edguez-Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Microbiology Clinical Unit, Valme University Hospital, Institute of Biomedicine of Seville (IBiS), University of Seville, 41004 Sevilla, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6501-9867","authenticated-orcid":false,"given":"Jose-Manuel","family":"Ramos-Rinc\u00f3n","sequence":"additional","affiliation":[{"name":"Clinical Medicine Department, Miguel Hern\u00e1ndez University, 03202 Elche, Spain"},{"name":"Infectious Diseases Unit, Alicante General University Hospital, Alicante Institute of Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Garcia","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Vega Baja University Hospital, 03314 Orihuela, Spain"},{"name":"Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), 46020 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5408-281X","authenticated-orcid":false,"given":"Elisabet","family":"Delgado-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Sant Joan D\u2019Alacant University Hospital, 03550 Sant Joan D\u2019Alacant, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel Nicol\u00e1s","family":"Navarrete-Lorite","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Virgen Macarena University Hospital, 41009 Sevilla, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Concepcion","family":"Gil","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Marina Baixa Hospital, 03570 Villajoyosa, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7770-9321","authenticated-orcid":false,"given":"Mar\u00eda","family":"Tasias","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7477-2033","authenticated-orcid":false,"given":"Juan Jose","family":"Caston","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Reina Sof\u00eda University Hospital, 14004 C\u00f3rdoba, Spain"},{"name":"CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto Salud Carlos III (ISCIII), 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5663-8447","authenticated-orcid":false,"given":"David","family":"Vinuesa-Garcia","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, San Cecilio University Hospital, 18007 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Gomez-Ayerbe","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Virgen de la Victoria University Hospital, 29010 Malaga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco J. Mart\u00ednez","family":"Marcos","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Juan Ram\u00f3n Jimenez University Hospital, 21005 Huelva, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1120-8942","authenticated-orcid":false,"given":"Nicolas","family":"Merchante","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Microbiology Clinical Unit, Valme University Hospital, Institute of Biomedicine of Seville (IBiS), University of Seville, 41004 Sevilla, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8007-5739","authenticated-orcid":false,"given":"Juan Carlos","family":"Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Microbiology Service, Alicante General University Hospital, Alicante Institute of Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain"},{"name":"Clinical Medicine Department, Miguel Hern\u00e1ndez University, 03202 Elche, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1111\/apt.17975","article-title":"Review Article: The Epidemiology and Management of Clostridioides difficile Infection\u2014A Clinical Update","volume":"59","author":"Clarke","year":"2024","journal-title":"Aliment. 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