Clostridioides (Clostridium) difficile-associated diarrhea in equine in Minas Gerais, Brazil: clinical and microbiological characterization of six cases

Diniz, Amanda Nádia; Cruz, Diogo Soares Gonçalves; Ramos, Carolina Pantuzza; Júnior, Carlos Augusto de Oliveira; Winter, Isabella Caixeta; Lima, Jorge Tiburcio Barbosa de; Carvalho, Armando; Lobato, Francisco Carlos Faria; Silva, Rodrigo

doi:10.1590/0103-8478cr20200878

Cited by 4 publications

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References 34 publications

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“…However, typical clade 5 strains (RT078 and RT126) were detected in two patients (2.7%) but corresponded to more than 60% of the animal isolates in the present study. These results corroborate those of previous studies that failed to detect RT078 in humans in Brazil, whereas both RT078 and 126 have been already reported in several animal species, including swine, horses, and rodents [8,10,13,82,83]. This finding contrasts with reports in European countries and in North America, where RT078 seems to be common in both humans and animals [84,85].…”

Section: Plos Onesupporting

confidence: 90%

Characterization of the virulence of three novel clade 2 Clostridioides (Clostridium) difficile strains and a two-year screening in animals and humans in Brazil

et al. 2022

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Clostridioides (Clostridium) difficile infection (CDI) is an evolving global healthcare problem, and owing to the diverse and dynamic molecular epidemiology of C. difficile, new strains continue to emerge. In Brazil, only two cases of CDI due to the so called hypervirulent PCR ribotype (RT) 027 belonging to clade 2 have ever been reported, whereas incidence of CDI due to another “hypervirulent” RT078 (clade 5) has not yet been reported. In contrast, novel clade 2 strains have been identified in different hospitals. To better understand the epidemiology of CDIs in Brazil, this study aimed to genotypically and phenotypically characterize three novel Brazilian clade 2 strains (RT883, 884, and 885) isolated from patients with confirmed CDI. In addition, to better understand the circulating RTs, a two-year sampling was conducted in patients from the same hospital and in several domestic and wild animal species. The three strains examined showed lower production of A/B toxins than the control RT027, although two of these strains harbored a truncated tcdC gene. All strains showed swimming motility similar to that of RT027, while RT883 showed higher spore production than the reference strain. In the in vivo hamster model, the lethality of all strains was found to be similar to that of RT027. Both cgMLST and cgMLSA analyses revealed a high genetic similarity among the three-novel clade 2 isolates. In the two-year survey in animals and humans, RT883, 884, and 885 were not detected; however, three new RTs (RT988, RT989, and RT990) were isolated, two of which were genetically related to the three previously reported clade 2 strains. RT106 and RT126 were most frequently detected in humans (47.9%) and animals (57.9%), respectively. Furthermore, RT027 and RT078 were not detected in humans. The results of this study suggest that these novel clade 2 strains have virulence potential and that new strains from clade 2 continue to emerge in our setting, indicating the need for long-term local surveillance.

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