Antibiotic Resistance in Clostridium Difficile: A Rapidly Evolving Threat

Abstract

The bacteria, Clostridium difficile the main pathogen associated with nosocomial infections is a gram positive, anaerobic and forms spores. The host and pathogen reaction results in a wide array of manifestation of the disease which ranges at one end as asymptomatic carriage to the other end as severe; toxic megacolon and thus making the treatment with antibiotic a challenge. To add upon the Clostridium difficile shows antibiotic resistance making its eradication almost impossible. This antibiotic resistance of Clostridium difficile has made it a global challenge over the decades, making it impossible for us to come to a conventional antibiotic to treat infections by Clostridium difficile. Several new strains of Clostridium difficile have emerged following the unscrupulous use of antimicrobial agents and subsequent transfer of resistance-causing genes between virulent strains the subsequent generations. The resistance to antibiotics is still rampant and not in control, rather it is on rise as the bacteria has greater access to new host due to its mobility and very infectious nature. With the use of extended antimicrobial therapy, an acute danger of creating and spreading new resistant and multi-drug resistant strains always looms. Clostridium difficile, during its life cycle, produces spores, which give the organism the capacity to resist extremes of change in the environment. In a country such as India, with a high population density and thus forming a high potential platform for the spread of multidrug-resistant strains of Clostridium difficile isusually addressed. An understanding of the emergence of antibiotic resistance in Clostridium difficile, the mechanisms by which the Clostridium difficile acquires it and sensitivity to antibiotics becomes very important. Therefore, we present a review of the antibiotic resistance seen in Clostridium difficile. RT027 has emerged as the most virulent strain all the strain of Clostridium difficile. Drug resistance is via multiple pathways, including erm, cfr, tet, and rpo B genes, as well as Gyr A and Gyr B. Of these, tet is transferable to non-resistant strains. Thus, indiscriminate use of antibiotics has created multiple antibiotic resistant strains of Clostridium difficile. Judicious and planned antibiotic treatment is advisable.