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

文献类型： 外文期刊

第一作者： Zhou, Yanzi

作者： Zhou, Yanzi;Zhou, Wangxiao;Xiao, Tingting;Chen, Yunbo;Lv, Tao;Wang, Yuan;Zhang, Shuntian;Chi, Xiaohui;Kong, Xiaoyang;Shen, Ping;Xiao, Yonghong;Cai, Hongliu;Zhou, Kai;Zhou, Kai;Shan, Tongling

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关键词： Clostridioides difficile infection; asymptomatic carrier; multiple sources; comparative genome; transmission

期刊名称：EMERGING MICROBES & INFECTIONS （ 影响因子：7.163； 五年影响因子：7.329 ）

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年卷期： 2021 年 10 卷 1 期

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收录情况： SCI

摘要： Clostridioides difficile is the most common pathogen causing antibiotic-associated diarrhea. Previous studies showed that diverse sources, aside from C. difficile infection (CDI) patients, played a major role in C. difficile hospital transmission. This study aimed to investigate relationships and transmission potential of C. difficile strains from different sources. A prospective study was conducted both in the intensive care unit (ICU) and six livestock farms in China in 2018-2019. Ninety-eight strains from CDI patients (10 isolates), asymptomatic hospitalized carriers (55), the ICU environment (12), animals (14), soil (4), and farmers (3) were collected. Sequence type (ST) 3/ribotype (RT) 001, ST35/RT046, and ST48/RT596 were dominant types, distributed widely in multiple sources. Core-genome single-nucleotide polymorphism (cgSNP) analysis showed that hospital and farm strains shared several common clonal groups (CGs, strains separated by <= 2 cgSNPs) (CG4/ST3/RT001, CG7/ST35/RT046, CG11/ST48/RT596). CDI patients, asymptomatic carriers, and the ICU environment strains also shared several common CGs. The number of virulence genes was not statistically different between strains from different sources. Multi-source strains in the same CG carried identical virulence gene sequences, including pathogenicity genes at the pathogenicity locus and adhesion-related genes at S-layer cassette. Resistance genes (ermB, tetM, etc.) were widespread in multiple sources, and multi-source strains in the same CG had similar resistance phenotypes and carried consistent transposons and plasmid types. The study indicated that interspecies and cross-regional transmission of C. difficile occurs between animals, the environment, and humans. Community-associated strains from both farms and asymptomatic hospitalized carriers were important reservoirs of CDI in hospitals.

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