Table 3.
Antibiotics resistance-related genes of C. difficile strains based on the CARD
| ARO term | AMR gene family | Drug class | Resistance mechanism | C. difficile strain |
|---|---|---|---|---|
| C. difficile 23S rRNA with mutation conferring resistance to erythromycin and clindamycin | 23S rRNA with mutation conferring resistance to macrolide antibiotics | Macrolide, lincosamide | Antibiotic target alteration | All 60 strains |
| ErmB | Erm 23S ribosomal RNA methyltransferase | Macrolide, lincosamide, streptogramin | Antibiotic target alteration | CBA7201–CBA7203, CBA7205, CBA7207, CBA7209, 630, DSM 27639, DSM 29745, DSM 29688, DSM 28666, W0023a, R0104a, CD161, DSM 28669, M68 |
| vanRG | Glycopeptide resistance gene cluster, vanR | Glycopeptide | Antibiotic target alteration | CBA7201–CBA7209, 630, DSM 27639, DSM 29745, DSM 2,688, W0022a, DSM 29632, 08ACD0030, BR81, Mta-79, DSM 28666, DSM 29637, W0023a, FDAARGOS267, DH/NAP11/106/ST-42, W0003a, 20477, 20709, QCD-63q42, DSM 1296T, DSM 27638, DSM 27640, CD-17-01474, R0104a, 08-00495, 10–00253, 12-00011, 09-00072, 10-00078, 10-00071, 12-00008, CD-10-–00484, CD196, QCD-66c26 |
| vanXYG | Glycopeptide resistance gene cluster, vanXY | Glycopeptide | Antibiotic target alteration | CBA7201, CBA7203–CBA7209, 630, DSM 27639, DSM 29745, DSM 29688, W0022a, DSM 29632, 08ACD0030, BR81, Mta-79, DSM 28666, DSM 29637, W0023a, FDAARGOS267, DH/NAP11/106/ST-42, W0003a, 20477, 20709, QCD-63q42, DSM 1296T, DSM 27,638, DSM 27,640, CD-17–01,474, R0104a, 08-00495, 10-00253, 12-00011, 09-00072, 10-00078, 10-00071, 12-00008, CD-10-00484, CD196, QCD-66c26 |
| Clostridioides difficile gyrA conferring resistance to fluoroquinolones | Fluoroquinolone resistant gyrA | Fluoroquinolone | Antibiotic target alteration | CBA7201–CBA7203, CBA7205–CBA7207, CBA7209, DSM 29745, QCD-63q42, DSM 27638, DSM 27,640, CD-17-01474, R0104a, 08-00495, 10-00253, 12-00011, 10-00078, 10–00,071, 12-00008, CD-10-00484, QCD-66c26, VL 0104, VL 0391, CDT4, CD161, DSM 29747 |
| cdeA | Multidrug and toxic compound extrusion (MATE) transporter | Fluoroquinolone, acridine dye | Antibiotic efflux | CBA7209, 630, DSM 29745 |
| APH (2'')-If | APH(2'') | Aminoglycoside | Antibiotic inactivation | CBA7201–CBA7203, CBA7205, CBA7207, CBA7209, DSM 27638, DSM 27640 |
| AAC(6')-Ie-APH(2'')-Ia | APH(2''), AAC(6') | Aminoglycoside | Antibiotic inactivation | 630, ZJCDC-S82, CD161, M68 |
| aad(6) | ANT(6) | Aminoglycoside | Antibiotic inactivation | DSM 29020 |
| ANT(6)-Ia | ANT(6) | Aminoglycoside | Antibiotic inactivation | M120 |
| ANT(6)-Ib | ANT(6) | Aminoglycoside | Antibiotic inactivation | M120 |
| APH(3')-IIIa | APH(3') | Aminoglycoside | Antibiotic inactivation | CD21062 |
| catI | Chloramphenicol acetyltransferase (CAT) | Phenicol | Antibiotic inactivation | CD21062 |
| SAT-4 | Streptothricin acetyltransferase (SAT) | Nucleoside | Antibiotic inactivation | DSM 29020 |
| tet(40) | Major facilitator superfamily (MFS) antibiotic efflux pump | Tetracycline | Antibiotic efflux | DSM 29747, DSM 29020 |
| tet(44) | Tetracycline-resistant ribosomal protection protein | Tetracycline | Antibiotic target protection | M120 |
| tet(W/N/W) | Tetracycline-resistant ribosomal protection protein | Tetracycline | Antibiotic target protection | 630 |
| tetB(P) | Tetracycline-resistant ribosomal protection protein | Tetracycline | Antibiotic target protection | DSM 28669 |
| tetM | Tetracycline-resistant ribosomal protection protein | Tetracycline | Antibiotic target protection | DSM 28666, CDT4, DSM 29627, CD161, M68, DSM 29747, M120, CD21062, DSM 29020 |
| tetO | Tetracycline-resistant ribosomal protection protein | Tetracycline | Antibiotic target protection | CD21062 |
ARO antibiotic resistance ontology, AMR antimicrobial resistance
Strains CBA7201–CBA7209 isolated from Korean patients with CDI are highlighted in bold