A study investigating antimicrobial resistance in Clostridioides difficile (C. diff) isolates from pediatric patients in China found concerning levels of reduced susceptibility to metronidazole and vancomycin. Among 50 isolates collected between 2019 and 2022, resistance rates were 30% for metronidazole and 6% for vancomycin. All isolates were resistant to ceftriaxone and clindamycin, and 88% exhibited multidrug resistance. Whole-genome sequencing identified 16 potential antibiotic resistance genes (ARGs) related to resistance against aminoglycosides, fluoroquinolones, lincosamides, tetracyclines, and other antibiotic classes; however, plasmid pCD-METRO and vanA/B genes, typically linked to reduced susceptibility, were absent, indicating alternative resistance mechanisms.
The findings highlight the emergence of metronidazole- and vancomycin-resistant C. diff strains in children with C. diff, raising concerns about the effectiveness of current treatments. The study emphasizes the need for continued surveillance and further investigation into the genetic and molecular mechanisms underlying resistance in pediatric C. diff infections to inform more effective therapeutic strategies.
Reference: Li X, Wang Y, Cao R, et al. Antimicrobial Resistance of Clostridioides difficile in Children from a Tertiary Pediatric Hospital in Shanghai, China. Infect Drug Resist. 2024 Jan 26;17:329-339. doi: 10.2147/IDR.S441312. PMID: 38293314; PMCID: PMC10826549.
