Two Distinct Patterns of Clostridium difficile Diversity Across Europe Indicating Contrasting Routes of Spread
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.18/6269 |
Resumo: | EUCLID study group. European coordinators: INSA - Monica Oleastro (National Institute of Health, Lisbon, Portugal) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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7160 |
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Two Distinct Patterns of Clostridium difficile Diversity Across Europe Indicating Contrasting Routes of SpreadClostridium difficileRoutes of SpreadTransmissionHealthcareCommunityWhole-genome SequencingInfecções GastrointestinaisEUCLID study group. European coordinators: INSA - Monica Oleastro (National Institute of Health, Lisbon, Portugal)Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6137122/Supplementary Data: Supplementary materials are available at Clinical Infectious Diseases online. Consisting of data provided by the authors to benefit the reader, the posted materials are not copyedited and are the sole responsibility of the authors, so questions or comments should be addressed to the corresponding authorBackground: Rates of Clostridium difficile infection vary widely across Europe, as do prevalent ribotypes. The extent of Europe-wide diversity within each ribotype, however, is unknown. Methods: Inpatient diarrheal fecal samples submitted on a single day in summer and winter (2012–2013) to laboratories in 482 European hospitals were cultured for C. difficile, and isolates the 10 most prevalent ribotypes were whole-genome sequenced. Within each ribotype, country-based sequence clustering was assessed using the ratio of the median number of single-nucleotide polymorphisms between isolates within versus across different countries, using permutation tests. Time-scaled Bayesian phylogenies were used to reconstruct the historical location of each lineage. Results: Sequenced isolates (n = 624) were from 19 countries. Five ribotypes had within-country clustering: ribotype 356, only in Italy; ribotype 018, predominantly in Italy; ribotype 176, with distinct Czech and German clades; ribotype 001/072, including distinct German, Slovakian, and Spanish clades; and ribotype 027, with multiple predominantly country-specific clades including in Hungary, Italy, Germany, Romania, and Poland. By contrast, we found no within-country clustering for ribotypes 078, 015, 002, 014, and 020, consistent with a Europe-wide distribution. Fluoroquinolone resistance was significantly more common in within-country clustered ribotypes (P = .009). Fluoroquinolone-resistant isolates were also more tightly clustered geographically with a median (interquartile range) of 43 (0–213) miles between each isolate and the most closely genetically related isolate, versus 421 (204–680) miles in nonresistant pairs (P < .001). Conclusions: Two distinct patterns of C. difficile ribotype spread were observed, consistent with either predominantly healthcare-associated acquisition or Europe-wide dissemination via other routes/sources, for example, the food chain.Oxford University Press/ Infectious Diseases Society of AmericaRepositório Científico do Instituto Nacional de SaúdeEyre, David W.Davies, Kerrie A.Davis, GeorginaFawley, Warren N.Dingle, Kate E.De Maio, NicolaKaras, AndreasCrook, Derrick W.Peto, Tim E.A.Walker, A SarahWilcox, Mark H.EUCLID Study Group2019-03-21T15:51:41Z2018-09-142018-09-14T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.18/6269engClin Infect Dis. 2018 Sep 14;67(7):1035-1044. doi: 10.1093/cid/ciy2521058-483810.1093/cid/ciy252info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-07-20T15:41:18Zoai:repositorio.insa.pt:10400.18/6269Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T18:40:53.319192Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Two Distinct Patterns of Clostridium difficile Diversity Across Europe Indicating Contrasting Routes of Spread |
title |
Two Distinct Patterns of Clostridium difficile Diversity Across Europe Indicating Contrasting Routes of Spread |
spellingShingle |
Two Distinct Patterns of Clostridium difficile Diversity Across Europe Indicating Contrasting Routes of Spread Eyre, David W. Clostridium difficile Routes of Spread Transmission Healthcare Community Whole-genome Sequencing Infecções Gastrointestinais |
title_short |
Two Distinct Patterns of Clostridium difficile Diversity Across Europe Indicating Contrasting Routes of Spread |
title_full |
Two Distinct Patterns of Clostridium difficile Diversity Across Europe Indicating Contrasting Routes of Spread |
title_fullStr |
Two Distinct Patterns of Clostridium difficile Diversity Across Europe Indicating Contrasting Routes of Spread |
title_full_unstemmed |
Two Distinct Patterns of Clostridium difficile Diversity Across Europe Indicating Contrasting Routes of Spread |
title_sort |
Two Distinct Patterns of Clostridium difficile Diversity Across Europe Indicating Contrasting Routes of Spread |
author |
Eyre, David W. |
author_facet |
Eyre, David W. Davies, Kerrie A. Davis, Georgina Fawley, Warren N. Dingle, Kate E. De Maio, Nicola Karas, Andreas Crook, Derrick W. Peto, Tim E.A. Walker, A Sarah Wilcox, Mark H. EUCLID Study Group |
author_role |
author |
author2 |
Davies, Kerrie A. Davis, Georgina Fawley, Warren N. Dingle, Kate E. De Maio, Nicola Karas, Andreas Crook, Derrick W. Peto, Tim E.A. Walker, A Sarah Wilcox, Mark H. EUCLID Study Group |
author2_role |
author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório Científico do Instituto Nacional de Saúde |
dc.contributor.author.fl_str_mv |
Eyre, David W. Davies, Kerrie A. Davis, Georgina Fawley, Warren N. Dingle, Kate E. De Maio, Nicola Karas, Andreas Crook, Derrick W. Peto, Tim E.A. Walker, A Sarah Wilcox, Mark H. EUCLID Study Group |
dc.subject.por.fl_str_mv |
Clostridium difficile Routes of Spread Transmission Healthcare Community Whole-genome Sequencing Infecções Gastrointestinais |
topic |
Clostridium difficile Routes of Spread Transmission Healthcare Community Whole-genome Sequencing Infecções Gastrointestinais |
description |
EUCLID study group. European coordinators: INSA - Monica Oleastro (National Institute of Health, Lisbon, Portugal) |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-09-14 2018-09-14T00:00:00Z 2019-03-21T15:51:41Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.18/6269 |
url |
http://hdl.handle.net/10400.18/6269 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Clin Infect Dis. 2018 Sep 14;67(7):1035-1044. doi: 10.1093/cid/ciy252 1058-4838 10.1093/cid/ciy252 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Oxford University Press/ Infectious Diseases Society of America |
publisher.none.fl_str_mv |
Oxford University Press/ Infectious Diseases Society of America |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799132151911809024 |