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© Research
Publication : Journal of Clinical Microbiology

Multilocus Variable-Number Tandem-Repeat Analysis of Clostridioides difficile Clusters in Ribotype 027 Isolates and Lack of Association with Clinical Outcomes

Scientific Fields
Diseases
Organisms
Applications
Technique

Published in Journal of Clinical Microbiology - 13 Feb 2019

Julian R. Garneau, Claire Nour Abou Chakra, Louis-Charles Fortier, Annie-Claude Labbé, Andrew E. Simor, Wayne Gold, Matthew Muller, Allison McGeer, Jeff Powis, Kevin Katz, Jacques Pépin and Louis Valiquette

Link to Pubmed [PMID] – 30760531

Journal of Clinical Microbiology Feb 2019, JCM.01724-18

The epidemiology of Clostridioides difficile infection (CDI) has drastically changed since the emergence of the epidemic strain BI/NAP1/027, also known as ribotype 027 (R027). However, the relationship between the infecting C. difficile strain and clinical outcomes is still debated. We hypothesized that certain subpopulations of R027 isolates could be associated with unfavorable outcomes. We applied high-resolution multilocus variable-number tandem-repeat analysis (MLVA) to characterize C. difficile R027 isolates collected from confirmed CDI patients recruited across 10 Canadian hospitals from 2005 to 2008. PCR ribotyping was performed first to select R027 isolates that were then analyzed by MLVA (n = 450). A complicated CDI (cCDI) was defined by the occurrence of any of admission to an intensive care unit, colonic perforation, toxic megacolon, colectomy, and if CDI was the cause or contributed to death within 30 days after enrollment. Three major MLVA clusters were identified, MC-1, MC-3, and MC-10. MC-1 and MC-3 were exclusive to Quebec centers while MC-10 was found only in Ontario. Fewer cases infected with MC-1 developed cCDI (4%) than those infected with MC-3 and MC-10 (15 and 16% respectively) but statistically significant difference was not reached. Our data did not identify a clear association between subpopulations of R027 and different clinical outcomes, however, it confirmed the utility of MLVA’s higher discrimination potential to better characterize CDI populations in epidemiological analysis. For a patient with CDI, the progression toward an unfavorable outcome is a complex process that probably includes several interrelated strain and host characteristics.

https://www.ncbi.nlm.nih.gov/pubmed/30760531