Show simple item record

dc.contributor.authorKumar, N
dc.contributor.authorMiyajima, F
dc.contributor.authorHe, M
dc.contributor.authorRoberts, P
dc.contributor.authorSwale, A
dc.contributor.authorEllison, L
dc.contributor.authorPickard, D
dc.contributor.authorSmith, G
dc.contributor.authorMolyneux, R
dc.contributor.authorDougan, G
dc.contributor.authorParkhill, J
dc.contributor.authorWren, BW
dc.contributor.authorParry, CM
dc.contributor.authorPirmohamed, M
dc.contributor.authorLawley, TD
dc.date.accessioned2021-02-05T00:28:03Z
dc.date.available2021-02-05T00:28:03Z
dc.date.issued2016-03-15
dc.identifierpii: civ1031
dc.identifier.citationKumar, N., Miyajima, F., He, M., Roberts, P., Swale, A., Ellison, L., Pickard, D., Smith, G., Molyneux, R., Dougan, G., Parkhill, J., Wren, B. W., Parry, C. M., Pirmohamed, M. & Lawley, T. D. (2016). Genome-Based Infection Tracking Reveals Dynamics of Clostridium difficile Transmission and Disease Recurrence. CLINICAL INFECTIOUS DISEASES, 62 (6), pp.746-752. https://doi.org/10.1093/cid/civ1031.
dc.identifier.issn1058-4838
dc.identifier.urihttp://hdl.handle.net/11343/260017
dc.description.abstractBACKGROUND: Accurate tracking of Clostridium difficile transmission within healthcare settings is key to its containment but is hindered by the lack of discriminatory power of standard genotyping methods. We describe a whole-genome phylogenetic-based method to track the transmission of individual clones in infected hospital patients from the epidemic C. difficile 027/ST1 lineage, and to distinguish between the 2 causes of recurrent disease, relapse (same strain), or reinfection (different strain). METHODS: We monitored patients with C. difficile infection in a UK hospital over a 2-year period. We performed whole-genome sequencing and phylogenetic analysis of 108 strains isolated from symptomatic patients. High-resolution phylogeny was integrated with in-hospital transfers and contact data to create an infection network linking individual patients and specific hospital wards. RESULTS: Epidemic C. difficile 027/ST1 caused the majority of infections during our sampling period. Integration of whole-genome single nucleotide polymorphism (SNP) phylogenetic analysis, which accurately discriminated between 27 distinct SNP genotypes, with patient movement and contact data identified 32 plausible transmission events, including ward-based contamination (66%) or direct donor-recipient contact (34%). Highly contagious donors were identified who contributed to the persistence of clones within distinct hospital wards and the spread of clones between wards, especially in areas of intense turnover. Recurrent cases were identified between 4 and 26 weeks, highlighting the limitation of the standard <8-week cutoff used for patient diagnosis and management. CONCLUSIONS: Genome-based infection tracking to monitor the persistence and spread of C. difficile within healthcare facilities could inform infection control and patient management.
dc.languageEnglish
dc.publisherOXFORD UNIV PRESS INC
dc.titleGenome-Based Infection Tracking Reveals Dynamics of Clostridium difficile Transmission and Disease Recurrence
dc.typeJournal Article
dc.identifier.doi10.1093/cid/civ1031
melbourne.affiliation.departmentMicrobiology and Immunology
melbourne.affiliation.facultyMedicine, Dentistry & Health Sciences
melbourne.source.titleClinical Infectious Diseases
melbourne.source.volume62
melbourne.source.issue6
melbourne.source.pages746-752
dc.rights.licenseCC BY
melbourne.elementsid1080597
melbourne.contributor.authorDougan, Gordon
dc.identifier.eissn1537-6591
melbourne.accessrightsOpen Access


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record