The first Clostridium difficile ribotype 027 strain isolated in Taiwan

Lai, Mei-Ju; Chiueh, Tzong‐Shi; Huang, Zheng-Yi; Lin, Jung‐Chung

doi:10.1016/j.jfma.2015.02.006

Cited by 6 publications

(4 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The global emergence of the RT027 strain was responsible for multiple outbreaks and increased disease severity in Canada and the United States in 2001 ( 4 ). This strain has since spread to South America ( 5 – 7 ), China ( 8 ), Japan ( 9 ), Hong Kong ( 10 ), South Korea ( 11 , 12 ), Taiwan ( 13 ), Singapore ( 14 ), Australia ( 15 , 16 ), Saudi Arabia ( 17 ), Israel ( 18 ), New Zealand ( 19 ), and throughout Europe ( 5 , 20 – 28 ). Although RT027 remains the dominant clone in the United States, Europe has seen a decline in RT027 with a simultaneous increase in other virulent RTs, such as RT017 and RT078 ( 29 ).…”

Section: Introductionmentioning

confidence: 99%

Comparative Genome Analysis and Global Phylogeny of the Toxin Variant Clostridium difficile PCR Ribotype 017 Reveals the Evolution of Two Independent Sublineages

et al. 2017

View full text Add to dashboard Cite

The diarrheal pathogen Clostridium difficile consists of at least six distinct evolutionary lineages. The RT017 lineage is anomalous, as strains only express toxin B, compared to strains from other lineages that produce toxins A and B and, occasionally, binary toxin. Historically, RT017 initially was reported in Asia but now has been reported worldwide. We used whole-genome sequencing and phylogenetic analysis to investigate the patterns of global spread and population structure of 277 RT017 isolates from animal and human origins from six continents, isolated between 1990 and 2013. We reveal two distinct evenly split sublineages (SL1 and SL2) of C. difficile RT017 that contain multiple independent clonal expansions. All 24 animal isolates were contained within SL1 along with human isolates, suggesting potential transmission between animals and humans. Genetic analyses revealed an overrepresentation of antibiotic resistance genes. Phylogeographic analyses show a North American origin for RT017, as has been found for the recently emerged epidemic RT027 lineage. Despite having only one toxin, RT017 strains have evolved in parallel from at least two independent sources and can readily transmit between continents.

show abstract

Section: Introductionmentioning

confidence: 99%

Comparative Genome Analysis and Global Phylogeny of the Toxin Variant Clostridium difficile PCR Ribotype 017 Reveals the Evolution of Two Independent Sublineages

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Among these, 19 full text articles reporting on the detection of C. difficile ribotype 027 isolates were found, with 142 cases identified in eight regions ( Fig. 2 ) 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 . In 2000, the first C. difficile ribotype 027 case was reported in Japan by Sawabe et al 29 .…”

Section: Resultsmentioning

confidence: 99%

“…In addition, 11 (7.7%) isolates were reported in South Korea 23 24 30 34 . The remaining 17 C. difficile ribotype 027 isolates were sporadically reported case-by-case from Japan (n = 5) 22 28 29 32 33 , Saudi Arabia (n = 4) 19 , Singapore (n = 3) 27 , mainland China (n = 1) 35 , Taiwan (n = 2) 25 26 , Hong Kong (n = 1) 21 , and Qatar (n = 1) 18 ( Fig. 2 ).…”

Section: Resultsmentioning

confidence: 99%

The First Two Clostridium difficile Ribotype 027/ST1 Isolates Identified in Beijing, China–an Emerging Problem or a Neglected Threat?

Cheng

Xiao

Kudinha

et al. 2016

Sci Rep

View full text Add to dashboard Cite

Clostridium difficile hyper-virulent ribotype 027 strain has become a significant concern globally, but has rarely been reported in Asian countries including China. Recently, a retrospective single-center study in Beijing, China, detected two ribotype 027 C. difficile isolates from two patients coming for outpatient visits in 2012 and 2013. We performed a systematic investigation of the two isolates (and patients). Both C. difficile isolates had the typical PCR ribotype 027 profile; were positive for tcdA, tcdB and binary toxin genes; belonged to multilocus sequence type 1 (ST1); had typical ribotype 027 deletions in the tcdC gene; and were highly-resistant to fluoroquinolones; but had a different MLVA profile and were not genetically related to any previously reported international ribotype 027 clones. A review of the patients’ medical records showed that neither received appropriate antimicrobial treatment and were lost to follow-up after outpatient visits. We propose that C. difficile infections caused by ribotype 027 are probably a neglected problem in China, and the subsequent impact of unawareness of this problem is worrying. Appropriate testing assays and multi-center or national level surveillance for C. difficile infections and specifically for ribotype 027 should be introduced to provide essential data and guide future clinical practice.

show abstract

“…From 2013 to 2014, three RT027 C. difficil e strains were isolated from patients in Taiwan [ 5 , 15 , 16 ]. Among them, NCKUH-21 is the first strain to have a whole-genome sequence for genome comparison.…”

Section: Resultsmentioning

confidence: 99%

Comparative genomic analysis of Clostridium difficile ribotype 027 strains including the newly sequenced strain NCKUH-21 isolated from a patient in Taiwan

et al. 2017

View full text Add to dashboard Cite

Background Clostridium difficile is a Gram-positive anaerobe and the leading cause of antibiotic-associated diarrhea worldwide. The emergence of ribotype 027 (RT027) strains is associated with increased incidence of infection and mortality. To further understand the relationship between C. difficile NCKUH-21, a RT027 strain isolated from a patient in Taiwan, and other RT027 strains, we performed whole-genome shotgun sequencing on NCKUH-21 and comparative genomic analyses.ResultsThe genome size, G+C content, and gene number for the NCKUH-21 strain were determined to be similar to those for other C. difficile strains. The core genome phylogeny indicated that the five RT027 strains R20291, CD196, NCKUH-21, BI1, and 2007855 formed a clade. A pathogenicity locus, tcdR-tcdB-tcdE-orf-tcdA-tcdC, was conserved in the genome. A genomic region highly similar to the Clostridium phage CD38-2 was present in the NCKUH-21 strain but absent in the other RT027 strains and designated as the prophage NCKUH-21. The prophage NCKUH-21 genes were significantly higher in G+C content than the other genes in the NCKUH-21 genome, indicating that the prophage does not match the base composition of the host genome.ConclusionsThis is the first whole-genome analysis of a RT027 C. difficile strain isolated from Taiwan. Due to the high identity with CD38-2, the prophage identified in the NCKUH-21 genome has the potential to regulate toxin production. These results provide important information for understanding the pathogenicity of RT027 C. difficile in Taiwan.Electronic supplementary materialThe online version of this article (10.1186/s13099-017-0219-4) contains supplementary material, which is available to authorized users.

show abstract

The first Clostridium difficile ribotype 027 strain isolated in Taiwan

Cited by 6 publications

References 5 publications

Comparative Genome Analysis and Global Phylogeny of the Toxin Variant Clostridium difficile PCR Ribotype 017 Reveals the Evolution of Two Independent Sublineages

Comparative Genome Analysis and Global Phylogeny of the Toxin Variant Clostridium difficile PCR Ribotype 017 Reveals the Evolution of Two Independent Sublineages

The First Two Clostridium difficile Ribotype 027/ST1 Isolates Identified in Beijing, China–an Emerging Problem or a Neglected Threat?

Comparative genomic analysis of Clostridium difficile ribotype 027 strains including the newly sequenced strain NCKUH-21 isolated from a patient in Taiwan

Contact Info

Product

Resources

About