Journal
DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE
Volume 87, Issue 1, Pages 11-16Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.diagmicrobio.2016.09.023
Keywords
Clostridium difficile; Relapse; Reinfection
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Understanding the contribution of relapse and reinfection to recurrent Clostridium difficile infection (CDI) has implications for therapy and infection prevention, respectively. We used whole genome sequencing to determine the relation of C difficile strains isolated from patients with recurrent CDI at an academic medical center in the United States. Thirty-five toxigenic C. difficile isolates from 16 patients with 19 recurrent CDI episodes with median time of 53.5 days (range, 13-362) between episodes were whole genome sequenced on the Illumina MiSeq platform. In 84% (16) of recurrences, the cause of recurrence was relapse with prior strain of C difficile. In 16% (3) of recurrent episodes, reinfection with a new strain of C difficile was the cause. In conclusion, the majority of CDI recurrences at our institution were due to infection with the same strain rather than infection with a new strain. (C) 2016 Elsevier Inc. All rights reserved.
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