ArticleGenome biology2012
Microevolutionary analysis of Clostridium difficile genomes to investigate transmission.
Article in Genome biology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 134 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
134 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Asymptomatic carriers of toxigenic C. difficile in long-term care facilities: a meta-analysis of prevalence and risk factors.PloS one · 2015Pooled it
- Whole-genome sequencing demonstrates that fidaxomicin is superior to vancomycin for preventing reinfection and relapse of infection with Clostridium difficile.The Journal of infectious diseases · 2014Trial
- Genomic evolution and re-emergence of a multidrug-resistantEmerging microbes & infections · 2026Article
- One Health genomic insights into environmental and animal reservoirs of community-associatedApplied and environmental microbiology · 2026Article
- A longitudinal analysis of Clostridioides difficile virulence profiles across three geographic regions in Israel (2020-2022).Annals of clinical microbiology and antimicrobials · 2026Article
- Wastewater reuse for production of plant-based foods: does spore-formingApplied and environmental microbiology · 2026Review
- Phenotypic analysis of variousApplied and environmental microbiology · 2025Article
- Phenotypic analysis of variousbioRxiv : the preprint server for biology · 2025Article
- CRISPR-Cas spacer acquisition is a rare event in human gut microbiome.Cell genomics · 2025Article
- The potential of genomic epidemiology: capitalizing on its practical use for impact in the healthcare setting.Frontiers in public health · 2025Article
- Genomic study of EuropeanMicrobial genomics · 2024Article
- Defining the phylogenetics and resistome of the majorMicrobial genomics · 2024Article
- KmerAperture: Retaining k-mer synteny for alignment-free extraction of core and accessory differences between bacterial genomes.PLoS genetics · 2024Article
- Comparative Genomics of Clostridioides difficile.Advances in experimental medicine and biology · 2024Article
- Core genome multilocus sequence typing of Clostridioides difficile to investigate transmission in the hospital setting.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2023Article
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- Longitudinal genomic surveillance of carriage and transmission of Clostridioides difficile in an intensive care unit.Nature medicine · 2023Article
- Genomic epidemiology and transmission dynamics of recurrent Clostridioides difficile infection in Western Australia.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2023Article
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74 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors.
Funding
Abstract
backgroundThe control of Clostridium difficile infection is a major international healthcare priority, hindered by a limited understanding of transmission epidemiology for these bacteria. However, transmission studies of bacterial pathogens are rapidly being transformed by the advent of next generation sequencing.
resultsHere we sequence whole C. difficile genomes from 486 cases arising over four years in Oxfordshire. We show that we can estimate the times back to common ancestors of bacterial lineages with sufficient resolution to distinguish whether direct transmission is plausible or not. Time depths were inferred using a within-host evolutionary rate that we estimated at 1.4 mutations per genome per year based on serially isolated genomes. The subset of plausible transmissions was found to be highly associated with pairs of patients sharing time and space in hospital. Conversely, the large majority of pairs of genomes matched by conventional typing and isolated from patients within a month of each other were too distantly related to be direct transmissions.
conclusionsOur results confirm that nosocomial transmission between symptomatic C. difficile cases contributes far less to current rates of infection than has been widely assumed, which clarifies the importance of future research into other transmission routes, such as from asymptomatic carriers. With the costs of DNA sequencing rapidly falling and its use becoming more and more widespread, genomics will revolutionize our understanding of the transmission of bacterial pathogens.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.