Plasmid Acquisition Alters Vancomycin Susceptibility in Clostridioides difficile

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 ].…”

“…** Proposed effects and mechanism based on creation of dysfunctional mutant strains as described by Ðapa et al [ 28 ]. *** Plasmid encoding multiple genes hypothesized to impact vancomycin susceptibility by Pu et al; protein listed is most likely to be related as per author [ 26 ].…”

“…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 ]. 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 ].…”

“…The gut microbiome is an abundant source of extrachromosomal elements to be potentially transferred amongst bacteria due to the diverse inhabitants. Pu et al identified the plasmid pX18-498 in CDI-positive patients who were non-responders to vancomycin treatment [ 26 ]. When this plasmid was transferred to C. difficile isolates from vancomycin responders (MIC < 1 mg/L), the isolates exhibited an 8-fold decrease in susceptibility to vancomycin.…”

Carriage of three plasmids in a single human clinical isolate of Clostridioides difficile

“…In many Gram-positive pathogens, virulence factors are encoded on plasmids [3,4]. For C. difficile, sporadic reports indicate that toxins and resistance determinants can be carried on extrachromosomal elements [5][6][7]. It is estimated that ~10-70% of C. difficile isolates carry one or more plasmids, but information on plasmid functions is sparse [8].…”