ReviewVirulence2013
Hype or hypervirulence: a reflection on problematic C. difficile strains.
Review in Virulence, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 50 citations in OpenAlex.
- Whole-Genome Sequencing Analysis of ST1, ST11, ST17, and ST37Microorganisms · 2026Article
- Acquisition of a gene cluster inmSphere · 2026Article
- Naturally Occurring CodY Variants Alter Ligand Binding, DNA Target Affinity, and Virulence in Clostridioides difficile.Molecular microbiology · 2026Article
- A severe Clostridioides difficile ribotype 027 infection in Beijing, China, july 2024.BMC infectious diseases · 2025Article
- The Ambivalent Nature ofToxins · 2025Review
- AApplied and environmental microbiology · 2025Article
- Association of toxin-producing Clostridioides difficile with piglet diarrhea and potential transmission to humans.The Journal of veterinary medical science · 2024Article
- Clostridioides difficile Sporulation.Advances in experimental medicine and biology · 2024Review
- Analysis of Clostridioides difficile Infection in Children with Diarrhea in Two Hospitals in Southern Brazil.Current microbiology · 2023Article
- Toxin gene profiles and antimicrobial resistance ofIranian journal of microbiology · 2021Article
- What's a Biofilm?-How the Choice of the Biofilm Model Impacts the Protein Inventory ofFrontiers in microbiology · 2021Article
- From Nursery to Nursing Home: Emerging Concepts in Clostridioides difficile Pathogenesis.Infection and immunity · 2020Review
- Epigenomic characterization of Clostridioides difficile finds a conserved DNA methyltransferase that mediates sporulation and pathogenesis.Nature microbiology · 2020Article
- How Oxygen Availability Affects the Antimicrobial Efficacy of Host Defense Peptides: Lessons Learned from Studying the Copper-Binding Peptides Piscidins 1 and 3.International journal of molecular sciences · 2019Article
- Single cell analysis of nutrient regulation of Clostridioides (Clostridium) difficile motility.Anaerobe · 2019Article
- AnMicrobial genomics · 2019Article
- Expanding theJournal of bacteriology · 2019Article
- Clostridium difficile-associated Diarrhea in Developing Countries: A Systematic Review and Meta-Analysis.Infectious diseases and therapy · 2019Article
- Impact of CodY protein on metabolism, sporulation and virulence in Clostridioides difficile ribotype 027.PloS one · 2019Article
- Characterization of the virulence of a non-RT027, non-RT078 and binary toxin-positive Clostridium difficile strain associated with severe diarrhea.Emerging microbes & infections · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Clostridium difficile infections (CDI) have emerged as a major cause of healthcare associated disease, and recent epidemiological evidence also suggests an important role in community-acquired diarrhea. This increase is associated with specific types, especially PCR ribotypes 027 and 078, which are sometimes referred to as "hypervirulent". Over the past years major advances have been made in our understanding of C. difficile pathogenicity, with the identification and characterization of the major clostridial toxins TcdA and TcdB. However, the relation between the toxins, their regulation, and "hypervirulence" remain unclear. Here I review our current understanding of C. difficile pathogenicity and argue that "hypervirulent" is an inadequate term to describe PCR ribotypes 027 and 078, that the ability of C. difficile to cause problematic infections is a consequence of a multifactorial process that extends beyond toxins, sporulation, and antimicrobial resistance, and that vigilance is in order toward types that are closely related to ribotypes 027 and 078, but are currently not considered problematic.
Indexed as
Identifiers
What OpenQuestion holds
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.