ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2018
Clostridium difficile Whole Genome Sequencing Reveals Limited Transmission Among Symptomatic Children: A Single-Center Analysis.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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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
24 citing papers in PubMed, 33 citations in OpenAlex.
- Early-life colonization withScience (New York, N.Y.) · 2026Article
- Comparative effectiveness of metronidazole and vancomycin for treatment ofAntimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
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- Comparative Genomics of Clostridioides difficile.Advances in experimental medicine and biology · 2024Article
- Clostridioides difficile Infections: Prevention and Treatment Strategies.Advances in experimental medicine and biology · 2024Review
- Clostridioides difficile Infection in Children: Recent Updates on Epidemiology, Diagnosis, Therapy.Pediatrics · 2023Review
- Strategies to preventInfection control and hospital epidemiology · 2023Article
- Next Generation and Other Sequencing Technologies in Diagnostic Microbiology and Infectious Diseases.Genes · 2022Review
- Identification of Clostridium innocuum hypothetical protein that is cross-reactive with C. difficile anti-toxin antibodies.Anaerobe · 2022Article
- Risk for Asymptomatic Household Transmission of Clostridioides difficile Infection Associated with Recently Hospitalized Family Members.Emerging infectious diseases · 2022Article
- Whole-Genome Sequencing Reveals the High Nosocomial Transmission and Antimicrobial Resistance of Clostridioides difficile in a Single Center in China, a Four-Year Retrospective Study.Microbiology spectrum · 2022Article
- NGSocomial Infections: High-Resolution Views of Hospital-Acquired Infections Through Genomic Epidemiology.Journal of the Pediatric Infectious Diseases Society · 2021Review
- Genomic Features Associated with the Degree of Phenotypic Resistance to Carbapenems in Carbapenem-Resistant Klebsiella pneumoniae.mSystems · 2021Article
- Clostridioides difficile Whole-genome Sequencing Differentiates Relapse With the Same Strain From Reinfection With a New Strain.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Genotypic correlation between post discharge Clostridiodes difficle infection (CDI) and previous unit-based contacts.The Journal of hospital infection · 2021Article
- [Infection prevention in neonatal intensive care units].Der Gynakologe · 2021Review
- Natural Clostridioides difficile Toxin Immunization in Colonized Infants.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Diarrhoeal events can trigger long-term Clostridium difficile colonization with recurrent blooms.Nature microbiology · 2020Article
- Transmission ofInfection control and hospital epidemiology · 2020Article
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
Background: Although pediatric Clostridium difficile infections (CDIs) are increasing, C. difficile transmission patterns among children are poorly understood. Methods: We performed whole genome sequencing (WGS) on C. difficile isolates collected from children diagnosed with CDI between December 2012 and December 2013 at a single academic medical center. Genome sequences of isolates from CDIs diagnosed ≥8 weeks after study initiation were compared to all study isolate genome sequences. Among patients with isogenic isolates (≤2-3 core genome single nucleotide variants [SNVs] identified by pairwise SNV analyses), common inpatient and/or outpatient healthcare exposures were investigated. Results: Among 131 CDIs in 107 children, WGS identified 104 genetically distinct isolates. Of 84 incident CDIs occurring ≥8 weeks after study initiation, only 10 (11.9%) were caused by a strain isogenic to another cohort CDI isolate (putative transmission events). Proportions of each CDI class putatively associated with transmission were hospital-onset healthcare facility-associated (HCFA), 2/16 (12.5%); community-onset HCFA, 1/17 (5.9%); indeterminate, 1/11 (9.1%); community-associated (CA), 5/40 (12.5%); and recurrent, 1/21 (4.8%). Transmission events among CA and HCFA CDIs were similarly infrequent (5/40 [12.5%] vs 3/33 [9.1%]; P = .64). Shared healthcare facility exposures were only identified among 7/10 putative transmission events. Potential community transmission (same postal code) was not identified. Conclusions: WGS identified a highly diverse group of C. difficile isolates among children with CDI, including those with HCFA CDI. Clostridium difficile transmission among symptomatic children was very uncommon. Among putatively transmitted cases, investigation of shared healthcare exposures often did not identify a potential transmission source.
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