A subanalysis of Clostridium perfringens bloodstream infections from a 5-year retrospective nationwide survey (ITANAEROBY)

Clostridium perfingens bloodstream infections (BSIs) can be associated with high mortality rates. We performed a subanalysis of all C. perfringens BSIs enrolled during a multicentric retrospective observational study (ITANAEROBY). Data were collected from January 2016 to December 2020. C. perfringens BSIs were 134 (134/1960, 6.8 %). The highest resistance rate was observed for clindamycin (26/120, 21.6 %), penicillin (11/71, 15.4 %) and metronidazole (14/131, 10.7 %). In conclusion, C. perfringens reduced susceptibility phenotype to first-line therapy. •Data about the prevalence rate of antimicrobial-resistant C. perfringens are lacking and not uniform in the literature.•Clindamycin and metronidazole resistance is common worldwide, with a resistance rate of 21.3% and 10.7%, respectively.•Penicillin-binding proteins’ loss of affinity causes β-lactam resistance. β-lactamases and efflux pumps rarely play a role.•Penicillin resistance was highest in 2018 (22.2%) and lowest in 2019 (8.3%). Second-agent antibiotic resistance was rare.