Emergence and global spread of epidemic healthcare-associated Clostridium difficile.

Abstract:

:Epidemic C. difficile (027/BI/NAP1) has rapidly emerged in the past decade as the leading cause of antibiotic-associated diarrhea worldwide. However, the key events in evolutionary history leading to its emergence and the subsequent patterns of global spread remain unknown. Here, we define the global population structure of C. difficile 027/BI/NAP1 using whole-genome sequencing and phylogenetic analysis. We show that two distinct epidemic lineages, FQR1 and FQR2, not one as previously thought, emerged in North America within a relatively short period after acquiring the same fluoroquinolone resistance-conferring mutation and a highly related conjugative transposon. The two epidemic lineages showed distinct patterns of global spread, and the FQR2 lineage spread more widely, leading to healthcare-associated outbreaks in the UK, continental Europe and Australia. Our analysis identifies key genetic changes linked to the rapid transcontinental dissemination of epidemic C. difficile 027/BI/NAP1 and highlights the routes by which it spreads through the global healthcare system.

journal_name

Nat Genet

journal_title

Nature genetics

authors

He M,Miyajima F,Roberts P,Ellison L,Pickard DJ,Martin MJ,Connor TR,Harris SR,Fairley D,Bamford KB,D'Arc S,Brazier J,Brown D,Coia JE,Douce G,Gerding D,Kim HJ,Koh TH,Kato H,Senoh M,Louie T,Michell S,Butt E,Pea

doi

10.1038/ng.2478

subject

Has Abstract

pub_date

2013-01-01 00:00:00

pages

109-13

issue

1

eissn

1061-4036

issn

1546-1718

pii

ng.2478

journal_volume

45

pub_type

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