Two-year analysis of Clostridium difficile ribotypes associated with increased severity

Area of Science:

• Microbiology
• Infectious Diseases
• Epidemiology

Background:

• Certain Clostridium difficile (C. difficile) ribotypes are linked to severe disease and recurrence, notably the hypervirulent RT027.
• Understanding the spectrum of C. difficile ribotypes causing infection is crucial for assessing disease severity.

Purpose of the Study:

• To identify the prevalent C. difficile ribotypes responsible for infections.
• To investigate the association between specific ribotypes and disease severity, including mortality.

Main Methods:

• Faecal samples from 2011-2013 were tested for C. difficile.
• Isolates were ribotyped, and clinical/demographic data were collected and linked.

Main Results:

• 86 distinct C. difficile ribotypes were identified from 705 isolates.
• RT002 and RT015 were most common (22.5%). Hypervirulent RT027 was rare (0.7%).
• RT220 was associated with elevated C-reactive protein and significantly increased 30-day mortality compared to other prevalent ribotypes.

Conclusions:

• A diverse array of C. difficile ribotypes cause infections.
• While C. difficile mortality has decreased, emerging severe lineages like RT220 warrant enhanced surveillance.
• Genomic studies are needed to understand the pathogenicity of severe C. difficile strains.