Evidence map›Paper›PMID 40652164›Full record

ArticleBMC genomics2025

Mobile genetic elements mediating antimicrobial resistance drive the evolutionary process of Clostridioides difficile ST37/RT017.

Tao Lv, Xiajing Bi, Lisi Zheng, Yuhong Zhao, Yizheng Zhou, Tao Wu, Ping Shen, Danhua Zhu, Shiyao Chen, Yunbo Chen

Abstract read
In one paragraph

Article in BMC genomics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Pangenome-GWAS analysis ofCanadian journal of microbiology · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Tao Lv *State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Xiajing Bi *Department of nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Lisi ZhengState Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Yuhong ZhaoDepartment of Blood Transfusion, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Yizheng ZhouJingzhou Hospital Affiliated to Yangtze University, Jingzhou, China.
Tao WuMedical Engineering Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Ping ShenState Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Danhua ZhuState Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Shiyao ChenCollege of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China.
Yunbo ChenState Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. chenyunbo@aliyun.com.

Funding

National Nature Science Foundation of China 82073609the National Key Research and Development Program of China 2020YFE0204300
6 · The paper itself

Abstract

backgroundClostridioides difficile (C. difficile) ST37/RT017 is one of the most prevalent genotypes, exhibiting resistance to multiple antimicrobial agents and widespread dissemination, particularly in East Asia. However, its evolutionary history and genetic adaptation remains limited. Here, we aimed to systematically assess the genetic diversity, key evolutionary events, and potential driving forces of C. difficile ST37/RT017.

resultsTo explored dynamic trends in the genomic characterization, diversity and changes, both phylogenetic and Bayesian evolutionary analyses revealed that the C. difficile ST37/RT017 strains were clustered into three variant lineages as a directed bus-like topology, from VL I, to VL II, and VL III. An incremental increase in the median number of resistance genes was observed, with one in VL I, five in VL II, and six in VL III. Distinguishing features included variations in resistance genes or fluoroquinolone resistance mutation, such as erm(B), tet(M), aac(6’)-Ie-aph(2’’)-Ia, ant(6)-Ia and gyrA (T82I). Further analysis of evolutionary mechanisms revealed that Tn916, carrying tet(M), was present in 87.9% (160/182) of VL III and 92.6% (163/176) of VL II, but only 4.1% (5/122) of VL I. The Tn6194-like element, carrying erm(B), was found in 25.3% (46/182) of VL II and 84.7% (149/176) of VL III, with none detected in VL I. Furthermore, other functional genes, especially srtB, were notable in C. difficile ST37/RT017, which gradually acquired resistance genes from VL I to VL II and VL III.

conclusionsThe systematically analysis in this study suggests that the acquisition of antibiotic resistance genes was the primary driver of adaptive evolution in C. difficile ST37/RT017. Horizontal gene transfer, particularly through mobile genetic elements is a key genetic mechanism in the adaptive evolution of C. difficile ST37/RT017. Based on these genetic profiles, the active establishment and optimization of a rational system for antibiotic use will be crucial to prevent the emergence of a C. difficile ST37/RT017 variant.

Indexed as

Clostridioides difficileDrug Resistance, BacterialEvolution, MolecularInterspersed Repetitive SequencesAnti-Bacterial AgentsGenetic VariationPhylogenyAnti-Bacterial AgentsAntibiotic resistance geneClostridioides difficile ST37/RT017Genomic epidemiologyMobile genetic elementsMultidrug resistance

Identifiers

PMID40652164
PMCPMC12255112

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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.