Clostridium difficile: Investigating transmission patterns between infected and colonized patients using whole genome sequencing
| Autor: | Mark H. Wilcox, Ian Schiller, Yves Longtin, Frédéric Raymond, Ling Yuan Kong, Jacques Corbeil, Anne-Marie Bourgault, A S Walker, Vivian G. Loo, Sophie Michaud, Baldwin Toye, Nandini Dendukuri, Louise Poirier, Nathalie Turgeon, Paul Brassard, Rodica Gilca, Matthew Oughton, Derrick W. Crook, Eric Frost, Andre Dascal, David W Eyre |
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| Rok vydání: | 2018 |
| Předmět: |
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 |
| Zdroj: | Clinical Infectious Diseases. 68(2) |
| ISSN: | 1537-6591 1058-4838 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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