Genetic relatedness, Virulence factors and Antimicrobial Resistance of C. difficile strains from hospitalized patients in a multicentric study in Brazil

Genetic Mechanisms of Vancomycin Resistance in Clostridioides difficile: A Systematic Review

“…Upon review of these additional three articles, they did not meet the inclusion criteria. After a full-text review, the same eight articles were identified for inclusion through either literature search strategies [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ].…”

“…These resistance genes have been well described in Enterococcus spp. and are also present in C. difficile , albeit without evidence of the same clinical implications [ 22 , 23 , 24 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ]. Multiple van gene clusters, including vanA, vanB, vanG, and vanW , and vanZ orthologs, have been identified in C. difficile and have been associated with elevated vancomycin MICs ( Table 1 ) [ 22 , 23 , 24 , 35 ].…”

“…and are also present in C. difficile , albeit without evidence of the same clinical implications [ 22 , 23 , 24 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ]. Multiple van gene clusters, including vanA, vanB, vanG, and vanW , and vanZ orthologs, have been identified in C. difficile and have been associated with elevated vancomycin MICs ( Table 1 ) [ 22 , 23 , 24 , 35 ]. The expression of these clusters is controlled by a two-component regulatory system, VanSR, that contains VanS, a membrane sensor kinase, and VanR, a cytoplasmic response regulator [ 23 , 30 ].…”

“…Although the process by which resistance is conferred is less well defined, vanA, vanB, vanW , and vanZ have been associated with vancomycin resistance in C. difficile as well [ 24 ]. These van genes disseminate vancomycin resistance amongst various bacterial genera via plasmid acquisition, with VanB-type spread specifically linked to plasmid Tn1549 [ 26 , 33 , 39 ].…”

“…These van genes disseminate vancomycin resistance amongst various bacterial genera via plasmid acquisition, with VanB-type spread specifically linked to plasmid Tn1549 [ 26 , 33 , 39 ]. Saldanha et al submitted seven clinical isolates from Brazil for whole-genome sequencing to identify and better understand the relationship between vancomycin-resistance genes and MIC in C. difficile [ 24 ]. Five out of the seven isolates had elevated MICs and one or more van genes present ( Table 1 ).…”