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Antimicrobial Agents and Chemotherapy, May 2007, p. 1840-1843, Vol. 51, No. 5
0066-4804/07/$08.00+0     doi:10.1128/AAC.01283-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Mutations in fusA Associated with Posttherapy Fusidic Acid Resistance in Clostridium difficile

Department of Infectious Diseases,¹ Department of Clinical Microbiology,² Örebro University Hospital, Örebro, Department of Clinical Sciences, Malmö, Lund University, Lund,³ Swedish Institute for Infectious Disease Control, Solna, Sweden⁴

Received 13 October 2006/ Returned for modification 10 November 2006/ Accepted 2 February 2007

In silico, we identified fusA (2,067 bp) in Clostridium difficile 630. Sequencing of fusA in posttherapy fusidic acid-resistant C. difficile isolates from 12 patients with C. difficile-associated diarrhea (CDAD) identified fusA mutations, one or two nonsynonymous substitutions, or in one case a deletion of one codon associated with resistance. Five of these mutations have previously been described in fusA of fusidic acid-resistant Staphylococcus aureus, but seven were novel fusA mutations. Fusidic acid monotherapy for CDAD seemed to rapidly select conserved resistant mutants.

Published ahead of print on 16 February 2007.

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