Bacterial genomes evolve through mutations, rearrangements or horizontal gene transfer. Besides the core genes encoding essential metabolic functions, bacterial genomes also harbour a number of accessory genes acquired by horizontal gene transfer that might be beneficial under certain environmental conditions. The horizontal gene transfer contributes to the diversification and adaptation of microorganisms, thus having an impact on the genome plasticity. A significant part of the horizontal gene transfer is or has been facilitated by genomic islands (GEIs). GEIs are discrete DNA segments, some of which are mobile and others which are not, or are no longer mobile, which differ among closely related strains. A number of GEIs are capable of integration into the chromosome of the host, excision, and transfer to a new host by transformation, conjugation or transduction. GEIs play a crucial role in the evolution of a broad spectrum of bacteria as they are involved in the dissemination of variable genes, including antibiotic resistance and virulence genes leading to generation of hospital ‘superbugs’, as well as catabolic genes leading to formation of new metabolic pathways. Depending on the composition of gene modules, the same type of GEIs can promote survival of pathogenic as well as environmental bacteria.

Over a 3-year period, 45% of C. difficile cases in Oxfordshire were genetically distinct from all previous cases. Genetically diverse sources, in addition to symptomatic patients, play a major part in C. difficile transmission. (Funded by the U.K. Clinical Research Collaboration Translational Infection Research Initiative and others.).

A multilocus sequence typing (MLST) system was developed for group B streptococcus (GBS). The system was used to characterize a collection (n ‫؍‬ 152) of globally and ecologically diverse human strains of GBS that included representatives of capsular serotypes Ia, Ib, II, III, V, VI, and VIII. Fragments (459 to 519 bp) of seven housekeeping genes were amplified by PCR for each strain and sequenced. The combination of alleles at the seven loci provided an allelic profile or sequence type (ST) for each strain. A subset of the strains were characterized by restriction digest patterning, and these results were highly congruent with those obtained with MLST. There were 29 STs, but 66% of isolates were assigned to four major STs. ST-1 and ST-19 were significantly associated with asymptomatic carriage, whereas ST-23 included both carried and invasive strains. All 44 isolates of ST-17 were serotype III clones, and this ST appeared to define a homogeneous clone that was strongly associated with neonatal invasive infections. The finding that isolates with different capsular serotypes had the same ST suggests that recombination occurs at the capsular locus. A web site for GBS MLST was set up and can be accessed at http://sagalactiae.mlst.net. The GBS MLST system offers investigators a valuable typing tool that will promote further investigation of the population biology of this organism.Streptococcus agalactiae, group B streptococcus (GBS), is an important human pathogen. It is the leading cause of neonatal sepsis in the United Kingdom (18) and the United States (23). It is regarded as an emerging pathogen in the elderly (13) and is a frequent cause of maternal sepsis. However, GBS is usually a commensal organism and can be isolated from the genitourinary and gastrointestinal tracts of up to 35% of healthy adults (1).Capsular serotyping has been one of the mainstays in the descriptive epidemiology of GBS. Nine capsular serotypes have been described (Ia, Ib, and II to VIII). Serotype III GBS strains are of particular importance, as they are responsible for the majority of infections, including meningitis, in neonates worldwide (22). Diverse lineages of serotype III strains can be distinguished with multilocus enzyme electrophoresis (12, 19), pulsed-field gel electrophoresis (20), and restriction digest pattern (RDP) analysis (2), and the lineages appear to vary in pathogenic potential.Multilocus sequence typing (MLST) is an unambiguous sequence-based typing method that involves sequencing approximately 500-bp fragments of seven housekeeping genes and has been used successfully to type strains and investigate the population structure of a number of human bacterial pathogens, including Neisseria meningitidis (16) and Streptococcus pneumoniae (9). MLST is particularly suitable for epidemiological studies because it provides data that can easily be compared between laboratories over the Internet.The primary aim of this study was to develop an MLST system for GBS. Secondary aims were to show that the system could be used on a di...