Clostridium requires higher concentrations of the metronidazole for inhibition

Q: Which of the Clostridium requires higher concentrations of  metronidazole for its inhibition?

Answer: Clostridium ramosum

Metronidazole is well known for its excellent bactericidal activity against  anaerobic gram-positive bacilli of clostridium spp. Said that, clostridium ramosum may require higher concentrations of the drug for inhibition.

  

Clostridium ramosum is a common enteric anaerobe but rare to cause infections. Case reports have been published stating it as the cause of bacteremia. 

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References:

1. Alexander CJ, Citron DM, Brazier JS, Goldstein EJ. Identification and antimicrobial resistance patterns of clinical isolates of Clostridium clostridioforme, Clostridium innocuum, and Clostridium ramosum compared with those of clinical isolates of Clostridium perfringens. J Clin Microbiol 1995; 33:3209.

2. Forrester JD, Spain DA. Clostridium ramosum bacteremia: case report and literature review. Surg Infect (Larchmt). 2014 Jun;15(3):343-6. doi: 10.1089/sur.2012.240. Epub 2013 Nov 27. PMID: 24283763.

3. Gerber JS, Berney-Meyer L, Segerer S. Clostridium Ramosum-A Rare Cause of Peritoneal Dialysis-Related Peritonitis. Perit Dial Int. 2018 May-Jun;38(3):231-232. doi: 10.3747/pdi.2017.00153. PMID: 29848602.

4. García-Jiménez A, Prim N, Crusi X, Benito N. Septic arthritis due to Clostridium ramosum. Semin Arthritis Rheum. 2016 Apr;45(5):617-20. doi: 10.1016/j.semarthrit.2015.09.009. Epub 2015 Oct 1. PMID: 26546506.