Journal article
Emergence and spread of predominantly community-onset Clostridium difficile PCR ribotype 244 infection in Australia, 2010 to 2012
Eurosurveillance, Vol.20(10), Article 21059
2015
Abstract
We describe an Australia-wide Clostridium difficile outbreak in 2011 and 2012 involving the previously uncommon ribotype 244. In Western Australia, 14 of 25 cases were community-associated, 11 were detected in patients younger than 65 years, 14 presented to emergency/outpatient departments, and 14 to non-tertiary/community hospitals. Using whole genome sequencing, we confirm ribotype 244 is from the same C. difficile clade as the epidemic ribotype 027. Like ribotype 027, it produces toxins A, B, and binary toxin, however it is fluoroquinolone-susceptible and thousands of single nucleotide variants distinct from ribotype 027. Fifteen outbreak isolates from across Australia were sequenced. Despite their geographic separation, all were genetically highly related without evidence of geographic clustering, consistent with a point source, for example affecting the national food chain. Comparison with reference laboratory strains revealed the outbreak clone shared a common ancestor with isolates from the United States and United Kingdom (UK). A strain obtained in the UK was phylogenetically related to our outbreak. Follow-up of that case revealed the patient had recently returned from Australia. Our data demonstrate new C. difficile strains are an on-going threat, with potential for rapid spread. Active surveillance is needed to identify and control emerging lineages.
Details
- Title
- Emergence and spread of predominantly community-onset Clostridium difficile PCR ribotype 244 infection in Australia, 2010 to 2012
- Authors/Creators
- D.W. Eyre (Author/Creator) - John Radcliffe HospitalL. Tracey (Author/Creator) - These authors contributed equally to the workB. Elliott (Author/Creator) - The University of Western AustraliaC. Slimings (Author/Creator) - Government of Western Australia Department of HealthP.G. Huntington (Author/Creator) - Royal North Shore HospitalR.L. Stuart (Author/Creator) - Monash UniversityT.M. Korman (Author/Creator) - Monash UniversityG. Kotsiou (Author/Creator) - Royal North Shore HospitalR. McCann (Author/Creator) - Government of Western Australia Department of HealthD. Griffiths (Author/Creator) - John Radcliffe HospitalW.N. Fawley (Author/Creator) - Leeds General InfirmaryP. Armstrong (Author/Creator) - Government of Western Australia Department of HealthK.E. Dingle (Author/Creator) - John Radcliffe HospitalA.S. Walker (Author/Creator) - John Radcliffe HospitalT.E. Peto (Author/Creator) - John Radcliffe HospitalD.W. Crook (Author/Creator) - John Radcliffe HospitalM.H. Wilcox (Author/Creator) - Leeds General InfirmaryT.V. Riley (Author/Creator) - School of Pathology and Laboratory Medicine
- Publication Details
- Eurosurveillance, Vol.20(10), Article 21059
- Publisher
- European Centre for Disease Prevention and Control (ECDC)
- Identifiers
- 991005541677607891
- Murdoch Affiliation
- Murdoch University
- Language
- English
- Resource Type
- Journal article
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- Collaboration types
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- Citation topics
- 1 Clinical & Life Sciences
- 1.120 Inflammatory Bowel Diseases & Infections
- 1.120.1133 Clostridium Infections
- Web Of Science research areas
- Infectious Diseases
- ESI research areas
- Immunology