☆ 4.6 Review

Update on Commonly Used Molecular Typing Methods for Clostridioides difficile

MICROORGANISMS (2023)

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Article Microbiology

Spore-Forming Clostridium (Clostridioides) difficile in Wastewater Treatment Plants in Western Australia

Jessica M. Chisholm et al.

Summary: This study reveals the common presence of toxigenic Clostridium difficile in wastewater treatment plants (WWTPs) in Western Australia, which are being released into the environment and becoming a potential source/reservoir for community-associated C. difficile infection (CA-CDI).

MICROBIOLOGY SPECTRUM (2023)

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Article Medicine, General & Internal

Assessment of Quality of Life Among Patients With Recurrent Clostridioides difficile Infection Treated with Investigational Oral Microbiome Therapeutic SER-109 Secondary Analysis of a Randomized Clinical Trial

Kevin W. Garey et al.

Summary: This secondary analysis of a phase 3 clinical trial investigated the association of SER-109 with health-related quality of life (HRQOL) in patients with recurrent Clostridioides difficile infection (CDI). The study found that SER-109 was associated with significant improvements in HRQOL compared to placebo, indicating its potential as an important treatment option for CDI patients.

JAMA NETWORK OPEN (2023)

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Article Infectious Diseases

Genomic epidemiology and transmission dynamics of recurrent Clostridioides difficile infection in Western Australia

Daniel R. Knight et al.

EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES (2023)

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Article Immunology

Application of a core genome sequence typing (cgMLST) pipeline for surveillance of Clostridioides difficile in China

Yuan Yuan Wang et al.

Summary: This study identified a core gene set and developed a cgMLST scheme for the phylogeny analysis of C. difficile using 699 whole genome sequences. The cgMLST pipeline successfully divided tested isolates into clades and identified an outbreak event. It offers a practical approach for national-wide surveillance of C. difficile in China.

FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY (2023)

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Article Microbiology

Clostridioides difficile, a New Superbug

Rumyana Markovska et al.

Summary: Clostridioides difficile is a Gram-positive, spore-forming, anaerobic bacterium that causes a range of clinical features, from asymptomatic carriage to severe pseudomembranous colitis. The infections are associated with disruption of the gut microbiota caused by antimicrobial agents.

MICROORGANISMS (2023)

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Article Food Science & Technology

The Environment, Farm Animals and Foods as Sources of Clostridioides difficile Infection in Humans

Declan Bolton et al.

Summary: The recent discovery of the same Clostridioides difficile ribotypes associated with human infection in a broad range of environments, animals, and foods, suggests that this pathogen may be transmitted through food. A review of the literature found that multiple ribotypes, including hypervirulent strains, have been detected in meat and vegetable food products, carrying pathogenic genes. A meta-analysis of the data suggests a higher risk of exposure to all ribotypes when consuming shellfish or pork, with the latter being the main foodborne route for the hypervirulent strains causing most human illnesses. Managing the risk of foodborne CDI is challenging due to multiple transmission routes and the resistance of C. difficile endospores to treatments.

FOODS (2023)

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Article Infectious Diseases

Clostridioides difficile infection with isolates of cryptic clade C-II: a genomic analysis of polymerase chain reaction ribotype 151

Quinten R. Ducarmon et al.

Summary: This study reports a patient case of pseudomembranous colitis caused by a rare polymerase chain reaction (PCR) ribotype (RT) 151 Clostridioides difficile strain that produces a single toxin. Genomic analysis revealed that the RT151 strain was unable to be identified using routine commercial tests. The study also provides conclusive evidence for the pathogenicity of C-II isolates of the cryptic clade and highlights the need for vigilance towards C. difficile infections caused by cryptic clade isolates.

CLINICAL MICROBIOLOGY AND INFECTION (2023)

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Review Microbiology

Clostridioides difficile infection and One Health: an equine perspective

Natasza M. R. Hain-Saunders et al.

Summary: Clostridioides difficile poses a significant health risk to both humans and animals, especially in equine populations. Current understanding of equine C. difficile infection is inadequate, highlighting the need for a holistic One Health approach to address this complex issue.

ENVIRONMENTAL MICROBIOLOGY (2022)

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Article Microbiology

Comparison of Whole-Genome Sequence-Based Methods and PCR Ribotyping for Subtyping of Clostridioides difficile

A. Baktash et al.

Summary: Clostridioides difficile is the most common cause of antibiotic-associated gastrointestinal infections. Capillary electrophoresis-PCR ribotyping is the current gold standard for C. difficile typing, but lacks the ability to study transmission and outbreaks in detail. New molecular methods, such as core genome multilocus sequence typing (cgMLST), have the potential to provide better differentiation and standardized data exchange. However, adjusted cutoff thresholds and epidemiological data are necessary to recognize outbreaks of specific ribotypes.

JOURNAL OF CLINICAL MICROBIOLOGY (2022)

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Article Microbiology

Presence of Clostridioides difficile in cattle feces, carcasses, and slaughterhouses: Molecular characterization and antibacterial susceptibility of the recovered isolates

Secil Abay et al.

Summary: This study isolated and identified Clostridioides difficile from cattle feces and slaughterhouse samples, some of which carried toxin genes, suggesting a potential risk of contamination to carcasses.

ANAEROBE (2022)

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Article Immunology

Genomic Analysis of Clostridioides difficile in 2 Regions of the United States Reveals a Diversity of Strains and Limited Transmission

Nicole Pecora et al.

Summary: The genomic epidemiology of Clostridioides difficile in two regions of the United States reveals a diverse strain profile and limited direct transmission.

JOURNAL OF INFECTIOUS DISEASES (2022)

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Review Food Science & Technology

An Update on Clostridioides difficile Binary Toxin

Adrian Martinez-Melendez et al.

Summary: Infection with Clostridioides difficile (CDI) is a common healthcare-associated infection that causes symptoms ranging from mild diarrhea to severe pseudomembranous colitis. The binary toxin (CDT) produced by approximately 20% of C. difficile strains is thought to enhance the toxicity of toxin A and toxin B, but the role of CDT in CDI remains controversial.

TOXINS (2022)

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Article Pharmacology & Pharmacy

Towards Development of a Non-Toxigenic Clostridioides difficile Oral Spore Vaccine against Toxigenic C. difficile

Jaime Hughes et al.

Summary: This study investigated the use of non-toxigenic Clostridioides difficile (NTCD) as a vector to induce antibodies that block the adherence of C. difficile to epithelial cells in the first stage of pathogenesis. The results showed that oral immunization with the T7-0873 strain successfully induced intestinal antibodies that significantly reduced the adhesion of toxigenic C. difficile to Caco-2 cells.

PHARMACEUTICS (2022)

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Review Genetics & Heredity

Make It Less difficile: Understanding Genetic Evolution and Global Spread of Clostridioides difficile

Mariachiara Mengoli et al.

Summary: This review provides an up-to-date overview of the genetic variation of Clostridioides difficile, with a particular focus on its pathogenic genes and their correlation with clinical issues. The current typing techniques and global distribution of the most common ribotypes are also summarized. The future perspectives of genomic surveillance actions and new genetic engineering strategies are discussed.

GENES (2022)

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Article Microbiology

Detection of Plasmid-Mediated Resistance to Metronidazole in Clostridioides difficile from River Water

Alois Cizek et al.

Summary: A diverse spectrum of C. difficile strains was found in wastewater and surface water. Interestingly, a recently discovered plasmid-mediated resistance to metronidazole was detected in C. difficile from river water.

MICROBIOLOGY SPECTRUM (2022)

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Article Immunology

Molecular typing of Clostridioides difficile from frozen stool samples to investigate cross-transmissions: A proof of concept

Dominique S. Blanc et al.

Summary: The developed protocol allows for prospective and retrospective molecular and genomic epidemiological investigations of C. difficile infections for the purpose of infection control. Undetected chains of transmission were revealed and confirmed through molecular typing results.

INDIAN JOURNAL OF MEDICAL MICROBIOLOGY (2022)

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Article Microbiology

What's a SNP between friends: The lineage of Clostridioides difficile R20291 can effect research outcomes

Jorge Monteford et al.

Summary: Clostridioides difficile R20291 is the most studied PCR-Ribotype 027 isolate, and its two predominant lineages show substantive phenotypic differences and slight differences in genomes. Considering the source of R20291 is important for research outcomes.

ANAEROBE (2021)

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Article Food Science & Technology

Prevalence and phylogenetic relationship of Clostridioides difficile strains in fresh poultry meat samples processed in different cutting plants

Janine Heise et al.

Summary: Clostridioides difficile is a common cause of nosocomial infections, but can also be transmitted to humans through contact with poultry meat, as demonstrated by a high contamination rate in fresh chicken meat with skin purchased in Germany. Additionally, related strains of common clinical isolates were found in the same cutting plants over an extended period, indicating the potential for long-term persistence or recurring contamination from the same source.

INTERNATIONAL JOURNAL OF FOOD MICROBIOLOGY (2021)

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Article Immunology

New ribotype Clostridioides difficile from ST11 group revealed higher pathogenic ability than RT078

Wenpeng Gu et al.

Summary: The study compared the performance of three C. difficile strains in vitro and their pathogenic ability in vivo using animal models. Results showed that the CD12038 strain exhibited higher levels of adhesion, tissue damage, and infection capacity than the other strains.

EMERGING MICROBES & INFECTIONS (2021)

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Article Microbiology

The Cytopathic Effect of Different Toxin Concentrations From Different Clostridioides difficile Sequence Types Strains in Vero Cells

Zohar Hamo et al.

Summary: Different strains of Clostridioides difficile produce varying levels of toxins that have different degrees of damage to host cells. However, no direct association was found between specific bacterial strains, toxin concentrations, and disease severity.

FRONTIERS IN MICROBIOLOGY (2021)

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Article Microbiology

Agricultural fertilization with poultry manure results in persistent environmental contamination with the pathogen Clostridioides difficile

Martinique Frentrup et al.

Summary: The study detected viable Clostridioides difficile in broiler faeces, manure, dust, and fertilized soil during a field experiment, suggesting long-term contamination of agricultural soil with manure-derived C. difficile and demonstrating the potential for airborne dispersal of C. difficile through dust emissions during manure application. Genomic relatedness of C. difficile isolates traced their origins to specific chicken farm, indicating zoonotic transmission potential of broiler-associated C. difficile.

ENVIRONMENTAL MICROBIOLOGY (2021)

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Article Infectious Diseases

Predictive factors, outcomes, and molecular epidemiology of Clostridioides difficile diarrhea in Brazilian hospitals

Evelyne Santana Girao et al.

Summary: This study in Latin America investigated the role of lineage of Clostridioides difficile strains in CDI patients and their treatment outcomes. The overall mortality rate of CDI patients was 19% with no deaths directly attributed to CDI. Oral metronidazole showed a high efficacy rate of 85% with a recurrence rate of 14%.

EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES (2021)

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Article Medicine, General & Internal

Antibiotic Resistances and Molecular Characteristics of Clostridioides difficile in ICUs in a Teaching Hospital From Central South China

Xiujuan Meng et al.

Summary: The majority of CDI patients in the study were caused by C. difficile isolates producing two toxins (A+B+CDT-), with ST3 being the most prevalent and all ST26 isolates being nontoxigenic. Despite over 50% of C. difficile isolates exhibiting multidrug resistance, metronidazole, tigecycline, fidaxomicin, and vancomycin were still effective treatments for CDI in our hospital.

FRONTIERS IN MEDICINE (2021)

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Article Infectious Diseases

Global Landscape of Clostridioides Difficile Phylogeography, Antibiotic Susceptibility, and Toxin Polymorphisms by Post-Hoc Whole-Genome Sequencing from the MODIFY I/II Studies

Hailong Zhao et al.

Summary: This study systematically characterized a global set of clinical trial C. difficile isolates, revealing geographic variability in clades, variability in toxin genes, and mutations associated with antibiotic susceptibility, indicating a highly complex interaction of C. difficile between host and environment. The dataset provides a valuable resource for validating findings and future research on C. difficile.

INFECTIOUS DISEASES AND THERAPY (2021)

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Article Biology

Major genetic discontinuity and novel toxigenic species in Clostridioides difficile taxonomy

Daniel R. Knight et al.

Summary: Research on over 12,000 C. difficile genomes revealed major taxonomic incoherence and clear species boundaries for the recently described cryptic clades CI-III. This discovery has significant implications for the global population structure of C. difficile and the Peptostreptococcaceae taxonomy as a whole. Additionally, the unique toxin gene architecture of these newly identified genomospecies may impact the diagnosis of CDI.

ELIFE (2021)

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Article Immunology

Transition From PCR-Ribotyping to Whole Genome Sequencing Based Typing of Clostridioides difficile

Helena M. B. Seth-Smith et al.

Summary: Clostridioides difficile infection can lead to nosocomial outbreaks, with WGS offering higher resolution epidemiological data compared to traditional PCR-ribotyping, although limitations exist in predicting ribotypes for certain strains.

FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY (2021)

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Article Microbiology

Decentralized Investigation of Bacterial Outbreaks Based on Hashed cgMLST

Carlus Deneke et al.

Summary: Whole-genome sequencing (WGS)-based outbreak investigation is a valuable method for bacterial pathogen surveillance, but faces challenges such as data exchange and reluctance to share metadata. chewieSnake is an intuitive cgMLST workflow that automates allele distance matrix computation, cluster membership, and phylogeny, with an interactive HTML report. It facilitates joint outbreak investigation by identifying shared clusters and providing a stable cluster nomenclature.

FRONTIERS IN MICROBIOLOGY (2021)

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Article Immunology

Genomic evolution and virulence association of Clostridioides difficile sequence type 37 (ribotype 017) in China

Xingxing Xu et al.

Summary: This study revealed the genetic characteristics and virulence association of Clostridioides difficile ST37 in China for the first time. Gene mutations in certain important metabolic pathways are associated with severe symptoms and correlated with higher virulence in C. difficile ST37 isolates.

EMERGING MICROBES & INFECTIONS (2021)

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Review Gastroenterology & Hepatology

Epidemiology of community-acquired and recurrent Clostridioides difficile infection

Yichun Fu et al.

Summary: Clostridioides difficile infection is a major issue in healthcare settings, with a rising incidence of community-associated infections. Patients with community-associated C. difficile tend to be younger with lower mortality rates. Although rates of recurrent C. difficile infection have decreased in the United States, further research and public health efforts are needed to address the changing epidemiology of this disease.

THERAPEUTIC ADVANCES IN GASTROENTEROLOGY (2021)

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Article Microbiology

Evaluation of a Combined Multilocus Sequence Typing and Whole-Genome Sequencing Two-Step Algorithm for Routine Typing of Clostridioides difficile

Mini Kamboj et al.

Summary: The study evaluated the potential of combining MLST with WGS for cost-saving routine C. difficile typing, showing high agreement between MLST and WGS. A two-step algorithm for routine typing yields significantly lower cost compared to routine use of WGS.

JOURNAL OF CLINICAL MICROBIOLOGY (2021)

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Article Microbiology

Quality assurance for genotyping and resistance testing of Clostridium (Clostridioides) difficile isolates - Experiences from the first inter-laboratory ring trial in four German speaking countries

Fabian K. Berger et al.

ANAEROBE (2020)

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Review Infectious Diseases

Clostridium difficile and One Health

S. C. Lim et al.

CLINICAL MICROBIOLOGY AND INFECTION (2020)

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Article Microbiology

Hash-Based Core Genome Multilocus Sequence Typing for Clostridium difficile

David W. Eyre et al.

JOURNAL OF CLINICAL MICROBIOLOGY (2020)

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Article Biotechnology & Applied Microbiology

Isolation and characterization of Clostridium difficile from a small survey of wastewater, food and animals in New Zealand

L. Rivas et al.

LETTERS IN APPLIED MICROBIOLOGY (2020)

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Article Chemistry, Applied

Presence of toxigenic Clostridioides (Clostridium) difficile in edible bivalve mollusks in Spain

Carmen Candel-Perez et al.

FOOD SCIENCE AND TECHNOLOGY INTERNATIONAL (2020)

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Article Multidisciplinary Sciences

Plasmid-mediated metronidazole resistance in Clostridioides difficile

Ilse M. Boekhoud et al.

NATURE COMMUNICATIONS (2020)

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Article Microbiology

Ribotype Classification ofClostridioides difficileIsolates Is Not Predictive of the Amino Acid Sequence Diversity of the Toxin Virulence Factors TcdA and TcdB

Zhenghui Li et al.

FRONTIERS IN MICROBIOLOGY (2020)

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Review Biochemical Research Methods

Molecular epidemiology of predominant and emerging Clostridioides difficile ribotypes

Adrian Martinez-Melendez et al.

JOURNAL OF MICROBIOLOGICAL METHODS (2020)

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Article Engineering, Environmental

Isolation and characterization of a multidrug-resistantClostridioides difficiletoxinotype V from municipal wastewater treatment plant

Akram Baghani et al.

JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE AND ENGINEERING (2020)

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Article Multidisciplinary Sciences

Whole genome sequencing of Clostridioides difficile PCR ribotype 046 suggests transmission between pigs and humans

Anders Werner et al.

PLOS ONE (2020)

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Typing methods based on whole genome sequencing data

Laura Uelze et al.

ONE HEALTH OUTLOOK (2020)

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Article Microbiology

Evolutionary and Genomic Insights into Clostridioides difficile Sequence Type 11: a Diverse Zoonotic and Antimicrobial-Resistant Lineage of Global One Health Importance

Daniel R. Knight et al.

MBIO (2019)

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Survey, characterization and antimicrobial susceptibility of Clostridium difficile from marine bivalve shellfish of North Adriatic Sea

Fabrizio Agnoletti et al.

INTERNATIONAL JOURNAL OF FOOD MICROBIOLOGY (2019)

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Article Microbiology

Ribotype variability of Clostridioides difficile strains in patients with hospital-acquired C. difficile infections, community-acquired C. difficile infections, and colonization with toxigenic and non-toxigenic strains of C. difficile

Bongyoung Kim et al.

ANAEROBE (2019)

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Review Public, Environmental & Occupational Health

Development and Implementation of Whole Genome Sequencing-Based Typing Schemes for Clostridioides difficile

Sandra Janezic et al.

FRONTIERS IN PUBLIC HEALTH (2019)

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Article Microbiology

A nationwide study of molecular epidemiology and antimicrobial susceptibility of Clostridioides difficile in South Korea

Jung-Hyun Byun et al.

ANAEROBE (2019)

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Article Infectious Diseases

WGS to determine the extent of Clostridioides difficile transmission in a high incidence setting in North Wales in 2015

David W. Eyre et al.

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY (2019)

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Molecular epidemiology of Clostridium difficile infection in Iranian hospitals

Parisa Shoaei et al.

ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL (2019)

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Clostridium difficile ribotype 017-characterization, evolution and epidemiology of the dominant strain in Asia

Korakrit Imwattana et al.

EMERGING MICROBES & INFECTIONS (2019)

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Recreational sandboxes for children and dogs can be a source of epidemic ribotypes of Clostridium difficile

Cristina Orden et al.

ZOONOSES AND PUBLIC HEALTH (2018)

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Article Public, Environmental & Occupational Health

Epidemiology and risk factors for Clostridium difficile-associated diarrhea in adult inpatients in a university hospital in China

Chenjie Tang et al.

AMERICAN JOURNAL OF INFECTION CONTROL (2018)

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Article Microbiology

Molecular epidemiology of Clostridioides (Clostridium) difficile strains recovered from clinical trials in the US, Canada and Europe from 2006-2009 to 2012-2015

Adam Cheknis et al.

ANAEROBE (2018)

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Article Veterinary Sciences

Preliminary studies on isolates of Clostridium difficile from dogs and exotic pets

Sara Andres-Lasheras et al.

BMC VETERINARY RESEARCH (2018)

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Review Infectious Diseases

New insights into transmission of Clostridium difficile infection-narrative review

A. Durovic et al.

CLINICAL MICROBIOLOGY AND INFECTION (2018)

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Article Infectious Diseases

Use of matrix-assisted laser desorption ionization-time of flight mass spectrometry to identify MLST clade 4 Clostridium difficile isolates

Jing-Wei Cheng et al.

DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE (2018)

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Article Infectious Diseases

Antimicrobial susceptibility of Clostridium difficile isolated from food and environmental sources in Western Australia

Su-Chen Lim et al.

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS (2018)

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Article Infectious Diseases

Molecular epidemiology and antimicrobial susceptibility of Clostridium difficile isolated from the Chinese People's Liberation Army General Hospital in China

Rui Wang et al.

INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES (2018)

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Article Microbiology

The emergence of Clostridium difficile PCR ribotype 078 in piglets in the Czech Republic clusters with Clostridium difficile PCR ribotype 078 isolates from Germany, Japan and Taiwan

Marcella Krutova et al.

INTERNATIONAL JOURNAL OF MEDICAL MICROBIOLOGY (2018)

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Article Microbiology

Defining and Evaluating a Core Genome Multilocus Sequence Typing Scheme for Genome-Wide Typing of Clostridium difficile

Stefan Bletz et al.

JOURNAL OF CLINICAL MICROBIOLOGY (2018)

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Article Microbiology

Molecular epidemiology and antimicrobial susceptibility of Clostridium difficile isolated from hospitals during a 4-year period in China

Yun-Bo Chen et al.

JOURNAL OF MEDICAL MICROBIOLOGY (2018)

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Article Immunology

High in vitro activity of fidaxomicin against Clostridium difficile isolates from a university teaching hospital in China

Jing-Wei Cheng et al.

JOURNAL OF MICROBIOLOGY IMMUNOLOGY AND INFECTION (2018)

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Article Medicine, General & Internal

Molecular epidemiology and antimicrobial susceptibility of human Clostridium difficile isolates from a single institution in Northern

Baoya Wang et al.

MEDICINE (2018)

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Article Immunology

Comparative genomics analysis of Clostridium difficile epidemic strain DH/NAP11/106

Larry K. Kociolek et al.

MICROBES AND INFECTION (2018)

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Article Ecology

Genome-Based Comparison of Clostridioides difficile: Average Amino Acid Identity Analysis of Core Genomes

Adriana Cabal et al.

MICROBIAL ECOLOGY (2018)

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Article Multidisciplinary Sciences

The zoonotic potential of Clostridium difficile from small companion animals and their owners

Denise Rabold et al.

PLOS ONE (2018)

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Article Microbiology

Incidence and Outbreak of Healthcare-Onset Healthcare-Associated Clostridioides difficile Infections Among Intensive Care Patients in a Large Teaching Hospital in China

Chunhui Li et al.

FRONTIERS IN MICROBIOLOGY (2018)

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Article Multidisciplinary Sciences

Novel Clade C-I Clostridium difficile strains escape diagnostic tests, differ in pathogenicity potential and carry toxins on extrachromosomal elements

Gabriel Ramirez-Vargas et al.

SCIENTIFIC REPORTS (2018)

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Article Veterinary Sciences

Quantification of Clostridioides (Clostridium) difficile in feces of calves of different age and determination of predominant Clostridioides difficile ribotype 033 relatedness and transmission between family dairy farms using multilocus variable-number tandem-repeat analysis

Petra Bandelj et al.

BMC VETERINARY RESEARCH (2018)

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Article Microbiology

The characteristics of Clostridium difficile ST81, a new PCR ribotype of toxin A- B plus strain with high-level fluoroquinolones resistance and higher sporulation ability than ST37/PCR ribotype 017

Baoya Wang et al.

FEMS MICROBIOLOGY LETTERS (2018)

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Presence of Clostridium difficile in pig faecal samples and wild animal species associated with pig farms

S. Andres-Lasheras et al.

JOURNAL OF APPLIED MICROBIOLOGY (2017)

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Prevalence and molecular characterization of Clostridium difficile isolates from a pig slaughterhouse, pork, and humans in Taiwan

Ying-Chen Wu et al.

INTERNATIONAL JOURNAL OF FOOD MICROBIOLOGY (2017)

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Clostridium difficile colonization and infection in patients with hepatic cirrhosis

Dong Yan et al.

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Community-acquired infection with hypervirulent Clostridium difficile isolates that carry different toxin and antibiotic resistance loci: a case report

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Ribotype 078 Clostridium difficile infection incidence in Dutch hospitals is not associated with provincial pig farming: Results from a national sentinel surveillance, 2009-2015

Sofie M. van Dorp et al.

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Article Multidisciplinary Sciences

Whole genome sequences of three Clade 3 Clostridium difficile strains carrying binary toxin genes in China

Rong Chen et al.

SCIENTIFIC REPORTS (2017)

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Community-associated Clostridium difficile infection in emergency department patients in Western Australia

Deirdre A. Collins et al.

ANAEROBE (2017)

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Sentinel community Clostridium difficile infection (CDI) surveillance in Scotland, April 2013 to March 2014

A. Banks et al.

ANAEROBE (2016)

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Reclassification of Clostridium difficile as Clostridioides difficile (Hall and O'Toole 1935) Prevot 1938

Paul A. Lawson et al.

ANAEROBE (2016)

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Article Microbiology

Molecular characterisation of Czech Clostridium difficile isolates collected in 2013-2015

M. Krutova et al.

INTERNATIONAL JOURNAL OF MEDICAL MICROBIOLOGY (2016)

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Article Public, Environmental & Occupational Health

Epidemiology of Clostridium difficile infections in Australia: enhanced surveillance to evaluate time trends and severity of illness in Victoria, 2010-2014

L. J. Worth et al.

JOURNAL OF HOSPITAL INFECTION (2016)

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Article Medicine, General & Internal

Clostridium difficile infection

Wiep Klaas Smits et al.

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Article Multidisciplinary Sciences

Molecular Characterization of Clostridium difficile Isolates from Human Subjects and the Environment

Tian-tian Tian et al.

PLOS ONE (2016)

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Article Multidisciplinary Sciences

More than 50% of Clostridium difficile Isolates from Pet Dogs in Flagstaff, USA, Carry Toxigenic Genotypes

Nathan E. Stone et al.

PLOS ONE (2016)

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Review Microbiology

Diversity and Evolution in the Genome of Clostridium difficile

Daniel R. Knight et al.

CLINICAL MICROBIOLOGY REVIEWS (2015)

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Review Food Science & Technology

A Possible Route for Foodborne Transmission of Clostridium difficile?

Barbara M. Lund et al.

FOODBORNE PATHOGENS AND DISEASE (2015)

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Article Medicine, General & Internal

Burden of Clostridium difficile Infection in the United States

Fernanda C. Lessa et al.

NEW ENGLAND JOURNAL OF MEDICINE (2015)

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Article Pathology

Molecular methods for detecting and typing of Clostridium difficile

Deirdre A. Collins et al.

PATHOLOGY (2015)

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Correction Multidisciplinary Sciences

Molecular Epidemiology of Clostridium difficile Infection in a Large Teaching Hospital in Thailand (vol 10, e0127026, 2015)

Popchai Ngamskulrungroj et al.

PLOS ONE (2015)

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Article Microbiology

Genomic diversity of Clostridium difficile strains

Sandra Janezic et al.

RESEARCH IN MICROBIOLOGY (2015)

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Article Veterinary Sciences

Investigation of Clostridium difficile interspecies relatedness using multilocus sequence typing, multilocus variable-number tandem-repeat analysis and antimicrobial susceptibility testing

C. Rodriguez et al.

VETERINARY JOURNAL (2015)

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Article Multidisciplinary Sciences

Development and Validation of an Internationally-Standardized, High-Resolution Capillary Gel-Based Electrophoresis PCR-Ribotyping Protocol for Clostridium difficile

Warren N. Fawley et al.

PLOS ONE (2015)

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Article Microbiology

Phenotypic and Genotypic Analysis of Clostridium difficile Isolates: a Single-Center Study

Yanjiao Zhou et al.

JOURNAL OF CLINICAL MICROBIOLOGY (2014)

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Article Multidisciplinary Sciences

ICU-Onset Clostridium difficile Infection in a University Hospital in China: A Prospective Cohort Study

Xiaohui Wang et al.

PLOS ONE (2014)

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Article Microbiology

Counterpoint: Is Clostridium difficile a food-borne disease?

Jane W. Marsh

ANAEROBE (2013)

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Review Microbiology

A clinical and epidemiological review of non-toxigenic Clostridium difficile

Mukil Natarajan et al.

ANAEROBE (2013)

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Article Immunology

Relationship Between Bacterial Strain Type, Host Biomarkers, and Mortality in Clostridium difficile Infection

A. Sarah Walker et al.

CLINICAL INFECTIOUS DISEASES (2013)

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Article Food Science & Technology

Presence of Clostridium difficile in pigs and cattle intestinal contents and carcass contamination at the slaughterhouse in Belgium

C. Rodriguez et al.

INTERNATIONAL JOURNAL OF FOOD MICROBIOLOGY (2013)

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Article Microbiology

Molecular epidemiology and resistance profiles of Clostridium difficile in a tertiary care hospital in Spain

Irene Weber et al.

INTERNATIONAL JOURNAL OF MEDICAL MICROBIOLOGY (2013)

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Article Microbiology

The agr Locus Regulates Virulence and Colonization Genes in Clostridium difficile 027

Melissa J. Martin et al.

JOURNAL OF BACTERIOLOGY (2013)

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Article Microbiology

Clostridium difficile Genotypes in Piglet Populations in Germany

Alexander Schneeberg et al.

JOURNAL OF CLINICAL MICROBIOLOGY (2013)

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Article Immunology

Relapse Versus Reinfection: Recurrent Clostridium difficile Infection Following Treatment With Fidaxomicin or Vancomycin

Iris Figueroa et al.

CLINICAL INFECTIOUS DISEASES (2012)

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Article Infectious Diseases

Clostridium difficile in Dutch animals: their presence, characteristics and similarities with human isolates

M. G. J. Koene et al.

CLINICAL MICROBIOLOGY AND INFECTION (2012)

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Article Infectious Diseases

Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance

A. -P. Magiorakos et al.

CLINICAL MICROBIOLOGY AND INFECTION (2012)

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Article Infectious Diseases

Comparative analysis of an expanded Clostridium difficile reference strain collection reveals genetic diversity and evolution through six lineages

Cornelis W. Knetsch et al.

INFECTION GENETICS AND EVOLUTION (2012)

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Article Microbiology

Clostridium difficile Mixed Infection and Reinfection

David W. Eyre et al.

JOURNAL OF CLINICAL MICROBIOLOGY (2012)

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Article Microbiology

Molecular and Microbiological Characterization of Clostridium difficile Isolates from Single, Relapse, and Reinfection Cases

Kentaro Oka et al.

JOURNAL OF CLINICAL MICROBIOLOGY (2012)

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Article Multidisciplinary Sciences

Macro and Micro Diversity of Clostridium difficile Isolates from Diverse Sources and Geographical Locations

Richard A. Stabler et al.

PLOS ONE (2012)

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Article Medicine, General & Internal

Characterisation of Clostridium difficile Hospital Ward-Based Transmission Using Extensive Epidemiological Data and Molecular Typing

A. Sarah Walker et al.

PLOS MEDICINE (2012)

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Article Infectious Diseases

Comparison of repetitive extragenic palindromic sequence-based PCR with PCR ribotyping and pulsed-field gel electrophoresis in studying the clonality of Clostridium difficile

T. Pasanen et al.

CLINICAL MICROBIOLOGY AND INFECTION (2011)

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Article Microbiology

Zero prevalence of Clostridium difficile in wild passerine birds in Europe

Petra Bandelj et al.

FEMS MICROBIOLOGY LETTERS (2011)

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Article Microbiology

Lack of Association between Clinical Outcome of Clostridium difficile Infections, Strain Type, and Virulence-Associated Phenotypes

Stephanie Sirard et al.

JOURNAL OF CLINICAL MICROBIOLOGY (2011)

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Article Microbiology

Prevalence and diversity of Clostridium difficile strains in infants

Clotilde Rousseau et al.

JOURNAL OF MEDICAL MICROBIOLOGY (2011)

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Article Multidisciplinary Sciences

Clinical Clostridium difficile: Clonality and Pathogenicity Locus Diversity

Kate E. Dingle et al.

PLOS ONE (2011)

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Article Microbiology

The Anti-Sigma Factor TcdC Modulates Hypervirulence in an Epidemic BI/NAP1/027 Clinical Isolate of Clostridium difficile

Glen P. Carter et al.

PLOS PATHOGENS (2011)

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Review Infectious Diseases

Clostridium difficile in food-innocent bystander or serious threat?

J. S. Weese

CLINICAL MICROBIOLOGY AND INFECTION (2010)

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Article Microbiology

Multilocus Sequence Typing of Clostridium difficile

David Griffiths et al.

JOURNAL OF CLINICAL MICROBIOLOGY (2010)

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Article Immunology

Molecular Epidemiology of Clostridium difficile over the Course of 10 Years in a Tertiary Care Hospital

Jaime Belmares et al.

CLINICAL INFECTIOUS DISEASES (2009)

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Article Pharmacology & Pharmacy

Clostridium difficile:: Recent epidemiologic findings and advances in therapy

Nicole L. McMaster-Baxter et al.

PHARMACOTHERAPY (2007)

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Article Microbiology

Typing and subtyping of Clostridium difficile isolates by using multiple-locus variable-number tandem-repeat analysis

Renate J. van den Berg et al.

JOURNAL OF CLINICAL MICROBIOLOGY (2007)

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Article Microbiology

Multilocus variable-number tandem-repeat analysis for investigation of Clostridium difficile transmission in hospitals

Jane W. Marsh et al.

JOURNAL OF CLINICAL MICROBIOLOGY (2006)

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Article Public, Environmental & Occupational Health

A modified pulsed-field get electrophoresis (PFGE) protocol for subtyping previously non-PFGE typeable isolates of Clostridium difficile polymerase chain reaction ribotype 001

M Gal et al.

JOURNAL OF HOSPITAL INFECTION (2005)

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Article Microbiology

Multilocus sequence analysis and comparative evolution of virulence-associated genes and housekeeping genes of Clostridium difficile

L Lemée et al.

MICROBIOLOGY-SGM (2005)

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Article Microbiology

An improved protocol for pulsed-field gel electrophoresis typing of Clostridium difficile

R Alonso et al.

JOURNAL OF MEDICAL MICROBIOLOGY (2005)

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Article Infectious Diseases

Typing of Clostridium difficile

JS Brazier

CLINICAL MICROBIOLOGY AND INFECTION (2001)

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Article Microbiology

Pulsed-field gel electrophoresis of degradation-sensitive DNAs from Clostridium difficile PCR ribotype 1 strains

JE Corkill et al.

JOURNAL OF CLINICAL MICROBIOLOGY (2000)

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Article Immunology

Analysis of the pathogenicity locus in Clostridium difficile strains

SH Cohen et al.

JOURNAL OF INFECTIOUS DISEASES (2000)

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