Origin, genomic diversity and microevolution of the Clostridium difficile B1/NAP1/RT027/ST01 strain in Costa Rica, Chile, Honduras and Mexico.

摘要: Clostridium difficile B1/NAP1/RT027/ST01 has been responsible for outbreaks of antibiotic-associated diarrhoea in clinical settings worldwide and is associated with severe disease presentations increased mortality rates. Two fluoroquinolone-resistant (FQR) lineages the epidemic strain emerged USA early 1990s disseminated trans continentally (FQR1 FQR2). However, it unclear when from where they entered Latin America (LA) whether isolates LA exhibit unique genomic features compared to other regions world. To answer first issue we whole-genome sequences (WGS) 25 typed as NAP1, RT027 or ST01 Costa Rica (n=16), Chile (n=5), Honduras (n=3) Mexico (n=1) WGS 129 global same genotype using Bayesian phylogenomics. The second question was addressed through a detailed analysis number type mutations their mobile resistome. All but two belong FQR2 lineage (n=23, 92 %), confirming its widespread distribution. As indicated by dataset composed 154 WGS, introduced into four countries analysed between 1998 2005 North (twice) Europe (at least times). These events occurred soon after emergence FQR more than one decade before report detection LA. A total 552 SNPs were identified across all genomes examined (3.8-4.3 Mb) pairwise comparisons R20291 reference genome. Moreover, SNP distances among smallest determined this species so far (0 55). Despite high level conservation, 39 (7 %) genes that play roles infection process (i.e. slpA) antibiotic resistance rpoB, fusA) distinguished isolates. In addition, Chile, had twice many (ARGs, n=4) related regions. Their set ARGs includes cfr-like gene tetM, which found part putative genetic elements whose resemble undescribed integrative conjugative elements. results show multiple, independent introductions FQR1 different geographical sources rather rapid accumulation distinct acquired ARG