<p>Whole genome analysis reveals new insights into the molecular characteristics of <em>Clostridioides difficile</em> NAP1/BI/027/ST1 clinical isolates in the People’s Republic of China</p>

Abstract

Background: The epidemic new strain NAP1/BI/027/ST-1 of Clostridioides difficile ( C. difficile ) causes more severe coliti and a higher mortality rate than historical strains. However, C. difficile NAP1/BI/027/ST-1 ( C. difficile RT027) infections have been rarely reported in Asia, particularly in China. Purpose: The objective of this study was to strengthen the understanding of the molecular characterizations of C. difficile RT027 in China. Patients and methods: Two C. difficile NAP1/BI/027/ST-1 were detected from two patients, and no additional isolates were found. Whole genome sequencing (WGS) was used to characterize two C. difficile RT027 isolates and control strain CD6 (from Hong Kong), and comparative genomic analysis was performed to compare genomic differences between seven isolates from Mainland China, CD6, and 10 isolates from North America and Europe. Results: The comparative genomic analysis revealed that isolates obtained from Mainlan China were outside of the two epidemic lineages, FQR1 and FQR2, and might have decreased virulence and transmissibility for outbreak. Furthermore, unique SNP mutations were detected in isolates obtained from Mainland China, which may affect the biological function of C. difficile . Conclusion: We speculate that C. difficile RT027 isolates in Mainland China may have different features, compared to those in North America and Europe.

Comparative genomic and transmission analysis of Clostridioides difficile between environmental, animal, and clinical sources in China

“…The isolates were confirmed as C. difficile as previously described [ 19 ]. The presence of tcdA , tcdB , and binary toxin genes ( cdtA , cdtB ) was detected by PCR as previously described [ 20 ]. Toxigenic strains of C. difficile were defined as positive for at least one toxin gene including tcdA , tcdB , or binary toxin genes, while non-toxigenic strains were absence of all toxin genes [ 21 ].…”

Molecular Epidemiology and Antimicrobial Resistance of Clostridioides difficile in Hospitalized Patients From Mexico

“…The molecular epidemiology of C. difficile infection (CDI) has shown that the bacterial genome and the disease have become very variable in the last decades. The incidence of CDI markedly increased worldwide at the end of the twentieth century ( Czepiel et al, 2019 ), which was associated with the rapid spread of the hypervirulent strain NAP1/B1/027/ST01 [North American Pulse field type 1/restriction endonuclease analysis type BI/ribotype 027/multilocus sequence typing (MLST)] ( Krutova et al, 2018 ; Lv et al, 2019 ; Guerrero-Araya et al, 2020 ). In addition, CDI cases attributed to other ribotypes such as RT078, RT001, RT018, and RT126 are emerging in Europe ( Couturier et al, 2018 ), and, currently, CDI is the most frequently identified health care–associated infection in the United States ( Guh and Kutty, 2018 ).…”

Community-acquired fulminant Clostridioides (Clostridium) difficile infection by ribotype 027 isolate in Japan: a case report

“…It is uncertain whether C. difficile ribotype 027 in Asia has similar virulence to that in North America or Europe. In the whole genomic analysis, two ribotype 027 strains isolated from two Chinese patients with CDI were outside of two distinct epidemic lineages of C. difficile ribotype 027 that emerged in North America, suggesting different features among those strains [16]. Cheng et al summarized 19 cases of ribotype 027 in Asia, which included only two cases of fulminant CDI [17].…”