ArticleMicrobial genomics2018
Genomic survey of Clostridium difficile reservoirs in the East of England implicates environmental contamination of wastewater treatment plants by clinical lineages.
Article in Microbial genomics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
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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.
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
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Prevalence of Clostridioides difficile contamination in healthcare and non-healthcare environments: a global systematic review and meta-analysis.International health · 2026Pooled it
- Systematic review of wastewater surveillance of antimicrobial resistance in human populations.Environment international · 2022Pooled it
- Wastewater reuse for production of plant-based foods: does spore-formingApplied and environmental microbiology · 2026Review
- Variety ofGerms · 2026Article
- Bacterial Communities and Resistance and Virulence Genes in Hospital and Community Wastewater: Metagenomic Analysis.International journal of molecular sciences · 2025Article
- The Role ofMicroorganisms · 2025Review
- Some Factors Influencing the Number ofInfection and drug resistance · 2025Article
- Non-human Clostridioides difficile Reservoirs and Sources: Animals, Food, Environment.Advances in experimental medicine and biology · 2024Article
- Update on Commonly Used Molecular Typing Methods forMicroorganisms · 2023Review
- The Environment, Farm Animals and Foods as Sources ofFoods (Basel, Switzerland) · 2023Article
- Spore-FormingMicrobiology spectrum · 2023Article
- Wastewater treatment plants, an "escape gate" for ESCAPE pathogens.Frontiers in microbiology · 2023Review
- Make It LessGenes · 2022Review
- Detection of Plasmid-Mediated Resistance to Metronidazole in Clostridioides difficile from River Water.Microbiology spectrum · 2022Article
- Wastewater surveillance of antibiotic-resistant bacterial pathogens: A systematic review.Frontiers in microbiology · 2022Review
- Mechanisms of antibiotic resistance of Clostridioides difficile.The Journal of antimicrobial chemotherapy · 2021Review
- Human and Porcine Transmission of Clostridioides difficile Ribotype 078, Europe.Emerging infectious diseases · 2021Article
- A common protocol for the simultaneous processing of multiple clinically relevant bacterial species for whole genome sequencing.Scientific reports · 2021Article
- Isolation and characterization of a multidrug-resistantJournal of environmental health science & engineering · 2020Article
- Novel and emerging sources of Clostridioides difficile infection.PLoS pathogens · 2019Review
Corrections and comments
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Authors and funding
15 authors at 4 institutions in 2 countries.
Funding
Abstract
There is growing evidence that patients with Clostridiumdifficile-associated diarrhoea often acquire their infecting strain before hospital admission. Wastewater is known to be a potential source of surface water that is contaminated with C. difficile spores. Here, we describe a study that used genome sequencing to compare C. difficile isolated from multiple wastewater treatment plants across the East of England and from patients with clinical disease at a major hospital in the same region. We confirmed that C. difficile from 65 patients were highly diverse and that most cases were not linked to other active cases in the hospital. In total, 186 C. difficile isolates were isolated from effluent water obtained from 18 municipal treatment plants at the point of release into the environment. Whole genome comparisons of clinical and environmental isolates demonstrated highly related populations, and confirmed extensive release of toxigenic C. difficile into surface waters. An analysis based on multilocus sequence types (STs) identified 19 distinct STs in the clinical collection and 38 STs in the wastewater collection, with 13 of 44 STs common to both clinical and wastewater collections. Furthermore, we identified five pairs of highly similar isolates (≤2 SNPs different in the core genome) in clinical and wastewater collections. Strategies to control community acquisition should consider the need for bacterial control of treated wastewater.
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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.