التفاصيل البيبلوغرافية
العنوان: |
Clostridioides difficile Whole-genome Sequencing Differentiates Relapse With the Same Strain From Reinfection With a New Strain |
المؤلفون: |
Cho, Janice, Cunningham, Scott, Pu, Meng, Lennon, Ryan J, Dens Higano, Jennifer, Jeraldo, Patricio, Sampathkumar, Priya, Shannon, Samantha, Kashyap, Purna C, Patel, Robin |
المصدر: |
Clin Infect Dis |
بيانات النشر: |
Oxford University Press |
سنة النشر: |
2020 |
مصطلحات موضوعية: |
Major Articles and Commentaries, envir, demo |
الوصف: |
BACKGROUND: Current approaches in tracking Clostridioides difficile infection (CDI) and individualizing patient management are incompletely defined. METHODS: We recruited 468 subjects with CDI at Mayo Clinic Rochester between May and December 2016 and performed whole-genome sequencing (WGS) on C. difficile isolates from 397. WGS was also performed on isolates from a subset of the subjects at the time of a recurrence of infection. The sequence data were analyzed by determining core genome multilocus sequence type (cgMLST), with isolates grouped by allelic differences and the predicted ribotype. RESULTS: There were no correlations between C. difficile isolates based either on cgMLST or ribotype groupings and CDI outcome. An epidemiologic assessment of hospitalized subjects harboring C. difficile isolates with ≤2 allelic differences, based on standard infection prevention and control assessment, revealed no evidence of person-to-person transmission. Interestingly, community-acquired CDI subjects in 40% of groups with ≤2 allelic differences resided within the same zip code. Among 18 subjects clinically classified as having recurrent CDI, WGS revealed 14 with initial and subsequent isolates differing by ≤2 allelic differences, suggesting a relapse of infection with the same initial strain, and 4 with isolates differing by >50 allelic differences, suggesting reinfection. Among the 5 subjects classified as having a reinfection based on the timing of recurrence, 3 had isolates with ≤2 allelic differences between them, suggesting a relapse, and 2 had isolates differing by >50 allelic differences, suggesting reinfection. CONCLUSIONS: Our findings point to potential transmission of C. difficile in the community. WGS better differentiates relapse from reinfection than do definitions based on the timing of recurrence. |
نوع الوثيقة: |
text |
اللغة: |
English |
العلاقة: |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7935391Test/ |
الإتاحة: |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7935391Test/ |
حقوق: |
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رقم الانضمام: |
edsbas.89181064 |
قاعدة البيانات: |
BASE |