Core genome multilocus sequence typing of Clostridioides difficile to investigate transmission in the hospital setting.
Eur J Clin Microbiol Infect Dis
; 42(12): 1469-1476, 2023 Dec.
Article
de En
| MEDLINE
| ID: mdl-37870711
ABSTRACT
PURPOSE:
Traditional epidemiological investigations of healthcare-associated Clostridioides difficile infection (HA-CDI) are often insufficient. This study aimed to evaluate a procedure that includes secondary isolation and genomic typing of single toxigenic colonies using core genome multilocus sequence typing (cgMLST) for the investigation of C. difficile transmission.METHODS:
We analyzed retrospectively all toxigenic C. difficile-positive stool samples stored at the Lausanne University Hospital over 6 consecutive months. All isolates were initially typed and classified using a modified double-locus sequence typing (DLST) method. Genome comparison of isolates with the same DLST and clustering were subsequently performed using cgMLST. The electronic administrative records of patients with CDI were investigated for spatiotemporal epidemiological links supporting hospital transmission. A comparative descriptive analysis between genomic and epidemiological data was then performed.RESULTS:
From January to June 2021, 86 C. difficile isolates were recovered from thawed samples of 71 patients. Thirteen different DLST types were shared by > 1 patient, and 13 were observed in single patients. A genomic cluster was defined as a set of isolates from different patients with ≤ 3 locus differences, determined by cgMLST. Seven genomic clusters were identified, among which plausible epidemiological links were identified in only 4/7 clusters.CONCLUSION:
Among clusters determined by cgMLST analysis, roughly 40% included unexplained HA-CDI acquisitions, which may be explained by unidentified epidemiological links, asymptomatic colonization, and/or shared common community reservoirs. The use of DLST, followed by whole genome sequencing analysis, is a promising and cost-effective stepwise approach for the investigation of CDI transmission in the hospital setting.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Clostridioides difficile
/
Infections à Clostridium
Limites:
Humans
Langue:
En
Journal:
Eur J Clin Microbiol Infect Dis
Sujet du journal:
DOENCAS TRANSMISSIVEIS
/
MICROBIOLOGIA
Année:
2023
Type de document:
Article
Pays d'affiliation:
Suisse