ArticleScientific reports2018
Novel Clade C-I Clostridium difficile strains escape diagnostic tests, differ in pathogenicity potential and carry toxins on extrachromosomal elements.
Article in Scientific reports, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
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31 citing papers in PubMed, 40 citations in OpenAlex.
- From colonization to infection: Genomic evolution of Clostridioides difficile pathogenesis.Cell reports · 2026Review
- Wastewater reuse for production of plant-based foods: does spore-formingApplied and environmental microbiology · 2026Review
- Clostridioides difficile pathogenesis and control.Nature reviews. Microbiology · 2026Review
- Virulome over taxonomy: refining the driver-passenger model in colorectal carcinogenesis.Frontiers in cellular and infection microbiology · 2026Review
- History and Evolution of the HypervirulentMicroorganisms · 2025Review
- Mobilome of Environmental Isolates ofAntibiotics (Basel, Switzerland) · 2025Article
- Use of PCR cycle threshold values for toxins A and B quantification in Clostridioides difficile infections.Scientific reports · 2025Article
- Allele-linked divergence in SlpA and TcdB drives distinct immune and cytotoxic responses that distinguish ST01 from non-ST01 strains in Clade 2 Clostridioides difficile.Access microbiology · 2025Article
- Distribution ofEmerging microbes & infections · 2024Article
- Diversity ofApplied and environmental microbiology · 2024Article
- Review
- Diagnostic testing and the evolution of detection avoidance by pathogens.Evolution, medicine, and public health · 2024Article
- Non-human Clostridioides difficile Reservoirs and Sources: Animals, Food, Environment.Advances in experimental medicine and biology · 2024Article
- Comparative Genomics of Clostridioides difficile.Advances in experimental medicine and biology · 2024Article
- Update on Commonly Used Molecular Typing Methods forMicroorganisms · 2023Review
- Make It LessGenes · 2022Review
- Identification of TFPI as a receptor reveals recombination-driven receptor switching in Clostridioides difficile toxin B variants.Nature communications · 2022Article
- Identification of novel, crypticMicrobial genomics · 2022Article
- Article
- Structural basis for selective modification of Rho and Ras GTPases byScience advances · 2021Article
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The population structure of Clostridium difficile currently comprises eight major genomic clades. For the highly divergent C-I clade, only two toxigenic strains have been reported, which lack the tcdA and tcdC genes and carry a complete locus for the binary toxin (CDT) next to an atypical TcdB monotoxin pathogenicity locus (PaLoc). As part of a routine surveillance of C. difficile in stool samples from diarrheic human patients, we discovered three isolates that consistently gave negative results in a PCR-based screening for tcdC. Through phenotypic assays, whole-genome sequencing, experiments in cell cultures, and infection biomodels we show that these three isolates (i) escape common laboratory diagnostic procedures, (ii) represent new ribotypes, PFGE-types, and sequence types within the Clade C-I, (iii) carry chromosomal or plasmidal TcdBs that induce classical or variant cytopathic effects (CPE), and (iv) cause different levels of cytotoxicity and hamster mortality rates. These results show that new strains of C. difficile can be detected by more refined techniques and raise questions on the origin, evolution, and distribution of the toxin loci of C. difficile and the mechanisms by which this emerging pathogen causes disease.
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