Molecular epidemiology and characterization of Clostridioides difficile isolates by multilocus sequence typing in...

Area of Science:

• Microbiology
• Epidemiology
• Genetics

Background:

• Clostridioides difficile infection (CDI) is a significant global health concern, causing healthcare-associated diarrhea and colitis.
• C. difficile exhibits substantial genetic variation across different lineages, impacting disease dynamics.

Purpose of the Study:

• To characterize the genetic diversity of C. difficile isolates in Iran.
• To identify specific sequence types (STs) and clades using multilocus sequence typing (MLST).

Main Methods:

• Utilized multilocus sequence typing (MLST) on seven housekeeping genes for 37 C. difficile isolates.
• Performed PCR to detect toxin-encoding and accessory genes within the pathogenicity locus.
• Employed goeBURST analysis to group sequence types into clades.

Main Results:

• Identified 33 distinct STs, including 28 novel types, with ST3 being the most prevalent.
• Grouped isolates into clade 1 (23 STs) and singletons (14 STs) via goeBURST analysis.
• Found associations between clades/singletons and community-acquired CDI, recurrent CDI, CDI severity, and antibiotic-associated diarrhea.

Conclusions:

• Demonstrated significant genetic heterogeneity among C. difficile isolates in Iran, highlighting ST3 dominance.
• Emphasized the necessity of molecular surveillance for understanding C. difficile epidemiology and population structure in the region.