Emergence and spread of predominantly community-onset Clostridium difficile PCR ribotype 244 infection in Australia, 2010 to 2012.

摘要: 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 detected patients younger than 65 years, presented to emergency/outpatient departments, non-tertiary/community hospitals. Using whole genome sequencing, we confirm 244 is from same C. clade as epidemic 027. Like 027, it produces toxins A, B, binary toxin, however fluoroquinolone-susceptible thousands single nucleotide variants distinct Fifteen isolates across Australia sequenced. Despite their geographic separation, all genetically highly related without evidence clustering, consistent with a point source, for example affecting national food chain. Comparison reference laboratory strains revealed clone shared common ancestor United States Kingdom (UK). A strain obtained UK was phylogenetically our outbreak. Follow-up that case patient had recently returned Australia. Our data demonstrate new are on-going threat, potential rapid spread. Active surveillance needed identify control emerging lineages.