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Whole genome analysis reveals new insights into the molecular characteristics of Clostridioides difficile NAP1/BI/027/ST1 clinical isolates in the People’s Republic of China

Authors Lv T, Chen Y, Guo L, Xu Q, Gu S, Shen P, Quan J, Fang Y, Chen L, Gui Q, Ye G, Li L

Received 28 January 2019

Accepted for publication 8 May 2019

Published 1 July 2019 Volume 2019:12 Pages 1783—1794


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Cristina Weinberg

Peer reviewer comments 2

Editor who approved publication: Professor Suresh Antony

Tao Lv,1,* Yunbo Chen1,* Lihua Guo,1 Qiaomai Xu,1 Silan Gu,1 Ping Shen,1 Jiazheng Quan,1 Yunhui Fang,1 Lifeng Chen,2 Qiaodi Gui,3 Guangyong Ye,4 Lanjuan Li1

1State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China; 2Medical Engineering Department, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China; 3Department of Clinical Laboratory, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, People’s Republic of China; 4Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China

*These authors contributed equally to this work

Background: The epidemic new strain NAP1/BI/027/ST-1 of Clostridioides difficile (C. difficile) causes more severe coliti and a higher mortality rate than historical strains. However, C. difficile NAP1/BI/027/ST-1 (C. difficile RT027) infections have been rarely reported in Asia, particularly in China.
Purpose: The objective of this study was to strengthen the understanding of the molecular characterizations of C. difficile RT027 in China.
Patients and methods: Two C. difficile NAP1/BI/027/ST-1 were detected from two patients, and no additional isolates were found. Whole genome sequencing (WGS) was used to characterize two C. difficile RT027 isolates and control strain CD6 (from Hong Kong), and comparative genomic analysis was performed to compare genomic differences between seven isolates from Mainland China, CD6, and 10 isolates from North America and Europe.
Results: The comparative genomic analysis revealed that isolates obtained from Mainlan China were outside of the two epidemic lineages, FQR1 and FQR2, and might have decreased virulence and transmissibility for outbreak. Furthermore, unique SNP mutations were detected in isolates obtained from Mainland China, which may affect the biological function of C. difficile.
Conclusion: We speculate that C. difficile RT027 isolates in Mainland China may have different features, compared to those in North America and Europe.

Keywords: People’s Republic of China, multilocus sequence typing, Clostridioides difficile infection, whole genome sequencing

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