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Related Experiment Video

Updated: Jan 13, 2026

Cefoperazone-treated Mouse Model of Clinically-relevant Clostridium difficile Strain R20291
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History and Evolution of the Hypervirulent Clostridioides difficile Ribotype 027 Lineage.

Isabella A Tickler1, Richard V Goering2, Fred C Tenover3

  • 1Cepheid, Sunnyvale, CA 94089, USA.

Microorganisms
|October 29, 2025
PubMed
Summary
This summary is machine-generated.

Clostridioides difficile PCR ribotype 027 (RT027) emerged as a hypervirulent strain causing healthcare-associated infections. This study clarifies the emergence, divergence, and decline of this significant C. difficile strain.

Keywords:
Clostridioides difficilebinary toxinglucosylating toxinspathogenesisribotyping

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Area of Science:

  • Microbiology
  • Genomics
  • Epidemiology

Background:

  • Clostridioides difficile is a major cause of healthcare-associated gastrointestinal infections globally.
  • The hypervirulent strain, Clostridioides difficile PCR ribotype 027 (RT027), significantly increased infection rates.
  • RT027 produces toxins A, B, and binary toxin, enhancing its pathogenicity.

Purpose of the Study:

  • To investigate the emergence, divergence, and decline of Clostridioides difficile RT027.
  • To integrate genomic data and published literature for a comprehensive analysis.
  • To understand the evolutionary history of this hypervirulent strain.

Main Methods:

  • Genomic data analysis
  • Literature review
  • Phylogenetic analysis to differentiate lineages

Main Results:

  • Clostridioides difficile RT027 emerged at least twice independently.
  • Two distinct RT027 lineages were identified, differing in fluoroquinolone resistance.
  • Other binary toxin-producing strains genetically related to RT027 have recently emerged.

Conclusions:

  • The emergence and spread of Clostridioides difficile RT027 had a substantial impact on healthcare.
  • Understanding the evolutionary dynamics of C. difficile strains is crucial for infection control.
  • Continued surveillance of emerging C. difficile strains is warranted.