ArticleScientific reports2019
Whole-genome sequencing reveals nosocomial Clostridioides difficile transmission and a previously unsuspected epidemic scenario.
Article in Scientific reports, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- Emergence of OXA-48-producingFrontiers in cellular and infection microbiology · 2026Article
- Distribution ofEmerging microbes & infections · 2024Article
- Whole-genome sequencing of toxigenic Clostridioides difficile reveals multidrug resistance and virulence genes in strains of environmental and animal origin.BMC veterinary research · 2024Article
- Impact of an Intervention Program onOpen forum infectious diseases · 2024Article
- Defining the phylogenetics and resistome of the majorMicrobial genomics · 2024Article
- Review
- Prolonged bacterial carriage and hospital transmission detected by whole genome sequencing surveillance.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- Comparative Genomics of Clostridioides difficile.Advances in experimental medicine and biology · 2024Article
- A local-scale One Health genomic surveillance ofMicrobial genomics · 2023Article
- Particular genomic and virulence traits associated with preterm infant-derived toxigenic Clostridium perfringens strains.Nature microbiology · 2023Article
- A novel approach to correcting attribution ofAntimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Whole-Genome Sequencing Surveillance and Machine Learning of the Electronic Health Record for Enhanced Healthcare Outbreak Detection.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Risk for Asymptomatic Household Transmission of Clostridioides difficile Infection Associated with Recently Hospitalized Family Members.Emerging infectious diseases · 2022Article
- A review of epidemiological models of Clostridioides difficile transmission and control (2009-2021).Anaerobe · 2022Review
- Computational approaches to understanding Clostridioides difficile metabolism and virulence.Current opinion in microbiology · 2022Review
- Whole-genome sequencing surveillance and machine learning for healthcare outbreak detection and investigation: A systematic review and summary.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2022Review
- Molecular epidemiology ofFrontiers in public health · 2022Article
- Unraveling a Nosocomial Outbreak of COVID-19: The Role of Whole-Genome Sequence Analysis.Open forum infectious diseases · 2021Article
- Evaluation of a Combined Multilocus Sequence Typing and Whole-Genome Sequencing Two-Step Algorithm for Routine Typing ofJournal of clinical microbiology · 2021Article
- A publicly accessible database forMicrobial genomics · 2020Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
To trace the routes and frequencies of transmission of Clostridioides difficile in a tertiary-care hospital in Madrid (Spain), we sequenced the genomes from all C. difficile isolates collected over 36 months (2014-2016) that were indistinguishable from any other isolate by PCR ribotyping. From a total of 589 C. difficile infection cases, we cultivated and PCR-ribotyped 367 C. difficile isolates (62%), of which 265 were genome-sequenced. Based on close relatedness of successively collected isolates (≤2 SNPs difference in their genomes), whole-genome sequencing revealed a total of 17 independent, putative transmission clusters, caused by various C. difficile strains and each containing 2 to 18 cases, none of which had been detected previously by standard epidemiological surveillance. Proportions of linked isolates varied widely among PCR ribotypes, from 3% (1/36) for ribotype 014/020 to 60% (12/20) for ribotype 027, suggesting differential aptitudes for nosocomial spread. Remarkably, only a minority (17%) of transmission recipients had direct ward contact to their presumed donors and specific C. difficile genome types frequently went undetectable for several months before re-emerging later, suggesting reservoirs for the pathogen outside of symptomatic patients. Taken together, our analysis based on genome sequencing suggested considerable within-hospital epidemic spread of C. difficile, even though epidemiological data initially had been inconspicuous.
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