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2015 ; 10
(10
): e0139811
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Tracing the Spread of Clostridium difficile Ribotype 027 in Germany Based on
Bacterial Genome Sequences
#MMPMID26444881
Steglich M
; Nitsche A
; von Müller L
; Herrmann M
; Kohl TA
; Niemann S
; Nübel U
PLoS One
2015[]; 10
(10
): e0139811
PMID26444881
show ga
We applied whole-genome sequencing to reconstruct the spatial and temporal
dynamics underpinning the expansion of Clostridium difficile ribotype 027 in
Germany. Based on re-sequencing of genomes from 57 clinical C. difficile
isolates, which had been collected from hospitalized patients at 36 locations
throughout Germany between 1990 and 2012, we demonstrate that C. difficile
genomes have accumulated sequence variation sufficiently fast to document the
pathogen's spread at a regional scale. We detected both previously described
lineages of fluoroquinolone-resistant C. difficile ribotype 027, FQR1 and FQR2.
Using Bayesian phylogeographic analyses, we show that fluoroquinolone-resistant
C. difficile 027 was imported into Germany at least four times, that it had been
widely disseminated across multiple federal states even before the first outbreak
was noted in 2007, and that it has continued to spread since.