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Clostridium difficile: Investigating transmission patterns between infected and colonized patients using whole genome sequencing
- Source :
- Clinical Infectious Diseases. 68(2)
- Publication Year :
- 2018
-
Abstract
- Background Whole genome sequencing (WGS) studies can enhance our understanding of the role of patients with asymptomatic Clostridium difficile colonization in transmission. Methods Isolates obtained from patients with Clostridium difficile infection (CDI) and colonization identified in a study conducted during 2006 - 2007 at six Canadian hospitals underwent typing by pulsed-field gel electrophoresis, multilocus sequence typing, and WGS. Isolates from incident CDI cases not in the initial study were also sequenced where possible. Ward movement and typing data were combined to identify plausible donors for each CDI case, as defined by shared time and space within predefined limits. Proportions of plausible donors for CDI cases that were colonized, infected, or both were examined. Results Five hundred and fifty-four isolates were sequenced successfully, 353 from colonized and 201 from CDI cases. The NAP1/027/ST1 strain was the most common strain, found in 124 (62%) of infected and 92 (26%) of colonized patients. A donor with a plausible ward link was found for 81 CDI cases (40%) using WGS with a threshold of ≤2 single nucleotide variants to determine relatedness. Sixty-five (32%) CDI cases could be linked to both infected and colonized donors. Exclusive linkages to infected and colonized donors were found for 28 (14%) and 12 (6%) CDI cases, respectively. Conclusion Colonized patients contribute to transmission, but CDI cases are more likely linked to other infected patients than colonized patients in this cohort with high rates of NAP1/027/ST1 strain, highlighting the importance of local prevalence of virulent strains in determining transmission dynamics.
- Subjects :
- Diarrhea
0301 basic medicine
Microbiology (medical)
DNA, Bacterial
genetic structures
030106 microbiology
Virulence
Single-nucleotide polymorphism
Article
Microbiology
03 medical and health sciences
0302 clinical medicine
Medicine
Humans
Colonization
030212 general & internal medicine
Typing
Articles and Commentaries
Whole genome sequencing
Cross Infection
Whole Genome Sequencing
Transmission (medicine)
business.industry
Clostridioides difficile
Clostridium difficile
3. Good health
Infectious Diseases
Carrier State
Clostridium Infections
Multilocus sequence typing
business
Genome, Bacterial
Subjects
Details
- ISSN :
- 15376591 and 10584838
- Volume :
- 68
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Clinical Infectious Diseases
- Accession number :
- edsair.doi.dedup.....edf2336211f1fb0c9b3febf1d3ff57ea