[1. Bartlett JG, Gerding DN. Clinical recognition and diagnosis of Clostridium difficile infection. Clin Infect Dis. 2008 Jan;46(Suppl 1):S12-S18. DOI: 10.1086/52186310.1086/52186318177217]Open DOISearch in Google Scholar
[2. Bloomfield LE, Riley TV. Epidemiology and risk factors for community-associated Clostridium difficile infection: a narrative review. Infect Dis Ther. 2016 Sep;5(3):231-51. DOI: 10.1007/s40121-016-0117-y10.1007/s40121-016-0117-y501997327370914]Open DOISearch in Google Scholar
[3. Rupnik M. Is Clostridium difficile-associated infection a potentially zoonotic and foodborne disease? Clin Microbiol Infect. 2007 May;13(5):457-9. DOI: 10.1111/j.1469-0691.2007.01687.x10.1111/j.1469-0691.2007.01687.x17331126]Open DOISearch in Google Scholar
[4. Hall IC, O’Toole E. Intestinal flora in new-born infants with a description of a new pathogenic anaerobe, Bacillus difficilis. Am J Dis Child. 1935;49(2):390-402. DOI: 10.1001/archpedi.1935.0197002010501010.1001/archpedi.1935.01970020105010]Open DOISearch in Google Scholar
[5. Voth DE, Ballard JD. Clostridium difficile toxins: mechanism of action and role in disease. Clin Microbiol Rev. 2005 Apr;18(2):247-263. DOI: 10.1128/ CMR.18.2.247-263.200510.1128/CMR.18.2.247-263.2005108279915831824]Open DOISearch in Google Scholar
[6. Wilcox MH, Chalmers JD, Nord CE, Freeman J, Bouza E. Role of cephalosporins in the era of Clostridium difficile infection. J Antimicrob Chemother. 2017 Jan;72(1):1-18. DOI: 10.1093/jac/dkw38510.1093/jac/dkw385516104827659735]Open DOISearch in Google Scholar
[7. Bartlett JG, Onderdonk AB, Cisneros RL, Kasper DL. Clindamycin-associated colitis due to a toxin-producing species of Clostridium in hamsters. J Infect Dis. 1977 Nov;136(5):701-5. DOI: 10.1093/infdis/136.5.70110.1093/infdis/136.5.701915343]Open DOISearch in Google Scholar
[8. Owens Jr RC, Donskey CJ, Gaynes RP, Loo VG, Muto CA. Antimicrobial-associated risk factors for Clostridium difficile infection. Clin Infect Dis. 2008 Jan;46(- Suppl 1):S19-S31. DOI: 10.1086/52185910.1086/52185918177218]Search in Google Scholar
[9. Baines SD, Wilcox MH. Antimicrobial resistance and reduced susceptibility in Clostridium difficile: potential consequences for induction, treatment, and recurrence of C. difficile infection. Antibiotics (Basel). 2015 Sep;4(3):267-8. DOI: 10.3390/antibiotics403026710.3390/antibiotics4030267479028527025625]Search in Google Scholar
[10. Spigaglia P. Recent advances in the understanding of antibiotic resistance in Clostridium difficile infection. Ther Adv Infect Dis. 2016 Feb;3(1):23-42. DOI: 10.1177/204993611562289110.1177/2049936115622891473550226862400]Search in Google Scholar
[11. McFarland LV, Ozen M, Dinleyici EC, Goh S. Comparison of pediatric and adult antibiotic-associated diarrhea and Clostridium difficile infections. World J Gastroenterol. 2016 Mar;22(11):3078-104. DOI: 10.3748/wjg.v22.i11.307810.3748/wjg.v22.i11.3078478998527003987]Open DOISearch in Google Scholar
[12. Freeman J, Vernon J, Vickers R, Wilcox MH. Susceptibility of Clostridium difficile isolates of varying antimicrobial resistance phenotypes to SMT19969 and 11 comparators. Antimicrob Agents Chemother. 2016 Jan;60(1):689-692. DOI: 10.1128/AAC.02000-1510.1128/AAC.02000-15470418726552981]Open DOISearch in Google Scholar
[13. Spigaglia P, Barbanti F, Mastrantonio P, on behalf of the European Study Group on Clostridium difficile (ESGCD). Multidrug resistance in European Clostridium difficile clinical isolates. J Antimicrob Chemother. 2011 Oct;66(10):2227-34. DOI: 10.1093/jac/dkr29210.1093/jac/dkr29221771851]Search in Google Scholar
[14. Vardakas KZ, Konstantelias AA, Loizidis G, Rafailidis PI, Falagas ME. Risk factors for development of Clostridium difficile infection due to BI/ NAP1/027 strain: a meta-analysis. Int J Infect Dis. 2012 Nov;16(11):e768-e773/. DOI: 10.1016/j.ijid.2012.07.01010.1016/j.ijid.2012.07.01022921930]Open DOISearch in Google Scholar
[15. Freeman J, Vernon J, Morris K, Nicholson S, Todhunter S, Longshaw C, et al. Pan-European longitudinal surveillance of antibiotic resistance among prevalent Clostridium difficile ribotypes. Clin Microbiol Infect. 2015 Mar; 21(3):248.e9-248.e16. DOI: 10.1016/j.cmi.2014.09.01710.1016/j.cmi.2014.09.01725701178]Open DOISearch in Google Scholar
[16. Farrow KA, Lyras D, Rood JI. Genomic analysis of the erythromycin resistance element Tn5398 from Clostridium difficile. Microbiology. 2001 Oct;147(10):2717-28. DOI: 10.1099/00221287-147-10-271710.1099/00221287-147-10-271711577151]Search in Google Scholar
[17. Spigaglia P, Mastrantonio P. Comparative analysis of Clostridium difficile clinical isolates belonging to different genetic lineages and time periods. J Med Microbiol. 2004 Nov;53(11):1129-36. DOI: 10.1099/jmm.0.45682-010.1099/jmm.0.45682-015496392]Open DOISearch in Google Scholar
[18. Dönhöfer A, Franckenberga S, Wicklesa S, Berninghausena O, Beckmann R, Wilson DN. Structural basis for TetM-mediated tetracycline resistance. Proc Natl Acad Sci U S A. 2012 Oct;109(42):16900-5. DOI: 10.1073/pnas.120803710910.1073/pnas.1208037109347950923027944]Open DOISearch in Google Scholar
[19. Mullany P, Wilks M, Lamb I, Clayton C, Wren B, Tabaqchali S. Genetic analysis of a tetracycline resistance element from Clostridium difficile and its conjugal transfer to and from Bacillus subtilis. J Gen Microbiol. 1990 Jul;136(7):1343-9. DOI: 10.1099/00221287-136-7-134310.1099/00221287-136-7-13432172445]Open DOISearch in Google Scholar
[20. Wang H, Mullany P. The large resolvase TndX is required and sufficient for integration and excision of derivatives of the novel conjugative transposon Tn5397. J Bacteriol. 2000 Dec;182(23):6577-83. DOI: 10.1128/JB.182.23.6577-6583.200010.1128/JB.182.23.6577-6583.200011139611073898]Open DOISearch in Google Scholar
[21. Spigaglia P, Carucci V, Barbanti F, Mastrantonio P. ErmB determinants and Tn916-like elements in clinical isolates of Clostridium difficile. Antimicrob Agents Chemother. 2005 Jun;49(6):2550-3. DOI: 10.1128/AAC.49.6.2550-2553.200510.1128/AAC.49.6.2550-2553.2005114053315917571]Open DOISearch in Google Scholar
[22. Fry PR, Thakur S, Abley M, Gebreyesa WA. Antimicrobial resistance, toxinotype, and genotypic profiling of Clostridium difficile isolates of swine origin. J Clin Microbiol. 2012 Jul;50(7):2366-72. DOI: 10.1128/JCM.06581-1110.1128/JCM.06581-11340560622518873]Open DOISearch in Google Scholar
[23. Spigaglia P, Barbanti F, Mastrantonio P. Tetracycline resistance gene tet(W) in the pathogenic bacterium Clostridium difficile. Antimicrob Agents Chemother.2008 Feb;52(2):770-3. DOI: 10.1128/AAC.00957-0710.1128/AAC.00957-07222477818070963]Open DOISearch in Google Scholar
[24. Kuijper EJ, Coignard B, Tüll P, on behalf of the ESCMID Study Group for Clostridium difficile (ESGCD), EU Member States and the European Centre for Disease Prevention and Control (ECDC). Emergence of Clostridium difficile-associated disease in North Americaand Europe. Clin Microbiol Infect. 2006 Oct;12(Suppl. 6):2-18. DOI: 10.1111/j.1469-0691.2006.01580.x10.1111/j.1469-0691.2006.01580.x16965399]Open DOISearch in Google Scholar
[25. Popescu GA, Șerban R, Pistol A, Niculcea A, Preda A, Lemeni D, et al. Clinical and microbiological characterization of Clostridium difficile infection in Romania (2013-2014); a hospital based study. BMC Infect Dis. 2014a;14(Suppl 7):o24. DOI: 10.1186/1471-2334-14-S7-O2410.1186/1471-2334-14-S7-O24]Open DOISearch in Google Scholar
[26. Popescu GA, Florea D, Rafila A. Clostridium difficile is emerging in Romania: a story of 027 ribotype and excessive antibiotic consumption. J Gastrointestin Liver Dis. 2014b;23(3):342-3.]Search in Google Scholar
[27. Florea D, Huhulescu S, Indra A, Badicut I, Rafila A, Otelea D, et al. PCR coupled with mass-spectrometry for detection of Clostridium difficile virulence markers during the emergence of ribotype 027 in Bucharest area. Rev Romana Med Lab. 2015;23(4):449-55. DOI:10.1515/rrlm-2015-004410.1515/rrlm-2015-0044]Open DOISearch in Google Scholar
[28. Macovei IS, Lemeni D, Usein CR, Șerban R, Niculcea A, Popescu GA, et al. The use of PCR Ribotyping for molecular typing of clinically significant Clostridium difficile Romanian isolates. Rom Biotechnol Lett.2017;22(5).]Search in Google Scholar
[29. The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters, version 7.1. 2017; http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/v_7.1_Breakpoint.]Search in Google Scholar
[30. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. CLSI document M100-27th ed. 2017:96-100.]Search in Google Scholar
[31. Marin M, Martín A, Alcalá LM, Cercenado E, Iglesias C, Reigadas E, et al. Clostridium difficile isolates with high linezolid MICs harbor the multiresistance gene cfr. Antimicrob Agents Chemother. 2015 Jan;59(1):586-9. DOI: 10.1128/AAC.04082-1410.1128/AAC.04082-14429143925385106]Open DOISearch in Google Scholar
[32. Marchese A, Ramirez M, Schito GC, Tomasz A. Molecular epidemiology of penicillin-resistant Streptococcus pneumoniae isolates recovered in Italy from 1993 to 1996. J Clin Microbiol. 1998 Oct;36(10):2944-9.10.1128/JCM.36.10.2944-2949.19981050929738048]Search in Google Scholar
[33. Baines SD, O’Connor R, Freeman J, Fawley WN, Harmanus C, Mastrantonio P, et al. Emergence of reduced susceptibility to metronidazole in Clostridium difficile. J Antimicrob Chemother. 2008 Nov;62(5):1046-52. DOI: 10.1093/jac/dkn31310.1093/jac/dkn31318693234]Open DOISearch in Google Scholar
[34. Marsh JW, Arora R, Schlackman JL, Shutt KA, Curry SR, Harrison LH. Association of relapse of Clostridium difficile disease with BI/NAP1/027. J Clin Microbiol. 2012 Dec;50(12):4078-82. DOI: 10.1128/JCM.02291-1210.1128/JCM.02291-12350298823052318]Open DOISearch in Google Scholar
[35. Cherian PT, Wu X, Yang L, Scarborough JS, Singh AP, Alam ZA, et al. Gastrointestinal localization of metronidazole by a lactobacilli-inspired tetramic acid motif improves treatment outcomes in the hamster model of Clostridium difficile infection. J Antimicrob Chemother. 2015 Nov;70(11):3061-9. DOI: 10.1093/jac/dkv23110.1093/jac/dkv231467726126286574]Open DOISearch in Google Scholar
[36. Robinson CD, Auchtung JM, Collins J, Britton RA. Epidemic Clostridium difficile strains demonstrate increased competitive fitness compared to nonepidemic isolates. Infect Immun. 2014 Jul;82(7):2815-25. DOI: 10.1128/IAI.01524-1410.1128/IAI.01524-14409762324733099]Open DOISearch in Google Scholar
[37. Lachowicz D, Pituch H, Obuch-Woszczatyński P. Antimicrobial susceptibility patterns of Clostridium difficile strains belonging to different polymerase chain reaction ribotypes isolated in Poland in 2012. Anaerobe. 2015 Feb;31:37-41. DOI: 10.1016/j.anaerobe.2014.09.00410.1016/j.anaerobe.2014.09.00425242196]Open DOISearch in Google Scholar
[38. Spigaglia P, Barbanti F, Mastrantonio P. Detection of a genetic linkage between genes coding for resistance to tetracycline and erythromycin in Clostridium difficile. Microb Drug Resist. 2007;13(2):90-5. DOI: 10.1089/mdr.2007.72310.1089/mdr.2007.72317650959]Open DOISearch in Google Scholar
[39. Knight DR, Elliott B, Chang BJ, Perkins TT, Riley TV. Diversity and evolution in the genome of Clostridium difficile. Clin Microbiol Rev. 2015 Jul;28(3):721-41. DOI: 10.1128/CMR.00127-1410.1128/CMR.00127-14447564526085550]Open DOISearch in Google Scholar
[40. Büchler AC, Rampini SK, Stelling S, Ledergerber B, Peter S, Schweiger A, et al. Antibiotic susceptibility of Clostridium difficile is similar worldwide over two decades despite widespread use of broad-spectrum antibiotics: an analysis done at the University Hospital of Zurich. BMC Infect Dis. 2014 Nov;14:607. DOI: 10.1186/s12879-014-0607-z10.1186/s12879-014-0607-z424776025425433]Open DOISearch in Google Scholar
[41. Curry SR, Marsh JW, Shutt KA, Muto CA, O’Leary MM, Saul MI, et al. High frequency of rifampin resistance identified in an epidemic Clostridium difficile clone from a large teaching hospital. Clin Infect Dis. 2009 Feb;48(4):425-9. DOI: 10.1086/59631510.1086/596315281916919140738]Open DOISearch in Google Scholar