Evidence map›Paper›PMID 40437588›Full record

ArticleAntimicrobial resistance and infection control2025

Whole genome sequence analysis reveals limited diversity among Clostridioides difficile ribotype 027 and 078 isolates collected in 22 hospitals in Berlin and Brandenburg, Germany.

Esther E Dirks, Vanessa Pfiffer, Genevieve Sohl, Fabian K Berger, Ina Friesen, Johannes Friesen, Ralf Ignatius, Johannes Elias, Alexander Mellmann, Mardjan Arvand

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Article in Antimicrobial resistance and infection control, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Esther E DirksUnit Hospital Hygiene, Infection Prevention and Control, Department for Infectious Diseases, Robert Koch Institute, Berlin, Germany.
Vanessa PfifferUnit Hospital Hygiene, Infection Prevention and Control, Department for Infectious Diseases, Robert Koch Institute, Berlin, Germany.
Genevieve SohlUnit Hospital Hygiene, Infection Prevention and Control, Department for Infectious Diseases, Robert Koch Institute, Berlin, Germany.
Fabian K BergerNational Reference Center for Clostridioides Difficile, Homburg Branch, Homburg/Saar, Germany.
Ina FriesenLabor Berlin - Charité Vivantes GmbH, Berlin, Germany.
Johannes FriesenMedizinisches Versorgungszentrum Labor 28 GmbH, Berlin, Germany.
Ralf IgnatiusMedizinisches Versorgungszentrum Labor 28 GmbH, Berlin, Germany.
Johannes EliasDRK Kliniken Berlin Westend, Berlin, Germany.
Alexander MellmannInstitute of Hygiene, University Hospital Muenster and National Reference Center for Clostridioides Difficile, Münster Branch, Münster, Germany.
Mardjan ArvandUnit Hospital Hygiene, Infection Prevention and Control, Department for Infectious Diseases, Robert Koch Institute, Berlin, Germany. arvandm@rki.de.

Funding

German Federal Ministry of Health ZMVI1-2519NIK703
6 · The paper itself

Abstract

backgroundClostridioides difficile infections (CDI) present significant health risks and are among the most important nosocomial infections. Ribotype (RT) 027 poses a particular risk due to its proposed "hypervirulence". Traditionally, C. difficile isolates are characterized using PCR-ribotyping. More recently, whole genome sequence (WGS) analysis is increasingly used, which may provide a higher discriminatory power. This study aimed to assess the distribution of different C. difficile RTs in hospitals in the Berlin-Brandenburg area, and to analyse the heterogeneity within isolates of different ribotypes using WGS.

methodsBetween February 2020 and November 2021, stool samples from patients with laboratory-confirmed CDI were collected from 22 hospitals (approximately 13,900 beds) in Berlin and Brandenburg. Toxigenic isolates (n = 476) were further characterized by ribotyping, antibiotic susceptibility testing, toxinotyping, and core genome multilocus sequence typing (cgMLST).

resultsSixty-five different RTs were detected, with RT014 (16.1%), RT027 (12.8%), and RT001 (7.6%) being the most prevalent. RT027 isolates exhibited resistance to several antibiotics. Further, cgMLST analysis revealed very close genetic relatedness between RT027 isolates despite being epidemiologically unrelated. Similar findings of a monomorphic population were observed for RT078 isolates. In contrast, other RTs showed a heterogenic population structure.

conclusionsThis study provides first insights into the distribution of C. difficile genotypes, corresponding antimicrobial resistance, and clonal relatedness using cgMLST, highlighting RT027 as the second most common genotype for the studied area. For the monomorphic RT027 and RT078 populations, new definitions of clonal relatedness might be necessary.

Indexed as

Clostridioides difficileClostridium InfectionsWhole Genome SequencingAdultAgedAnti-Bacterial AgentsBerlinCross InfectionFecesFemaleGenetic VariationGenome, BacterialGermanyHospitalsHumansMaleAnti-Bacterial AgentsClostridioides difficileClostridioides difficile infection (CDI)Core genome multilocus sequence typing (cgMLST)Ribotype 027Ribotype 078RibotypingWhole genome sequencing (WGS)

Identifiers

PMID40437588
PMCPMC12121276

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