Characterization of community-acquired Clostridioides difficile strains in Israel, 2020–2022

• DOI: 10.3389/fmicb.2023.1323257
• Publication Date: 2023-12-19T05:58:40Z
• Authors: Orna Schwartz; Hanan Rohana; Maya Azrad; Anna Shor; Nir Rainy; Yasmin Maor; Lior Nesher; Orli Sagi; Shifra Ken-Dror; Peter Kechker; Avi Peretz
• Keywords: Multilocus sequence typing; Etest; Clostridioides; Molecular Epidemiology

Background The prevalence of community-acquired Clostridioides difficile infection (CA-CDI) has been rising, due to changes in antibiotics prescribing practices, emergence hypervirulent strains and improved diagnostics. This study explored CA-CDI epidemiology by examining strain diversity virulence factors isolates collected across several geographical regions Israel. Methods Stool samples 126 patients were subjected PCR an immunoassay identify toxin genes proteins, respectively. Toxin loci PaLoc PaCdt detected whole-genome sequencing (WGS). Biofilm production was assessed crystal violet-based assay. Minimum inhibitory concentration determined using the Etest technique or agar dilution. WGS multi-locus sequence typing (MLST) used classify investigate genetic diversity. Results Sequence types (ST) 2 (17, 13.5%), ST42 (13, 10.3%), ST104 (10, 8%) ST11 (9, 7.1%) most common. All (117, 92.8%) but belonged Clade 1. No associations found between ST gender, geographic area antibiotic susceptibility. Although all harbored toxins genes, 34 (27%) produced A only, 54 (42.9%) B only; 38 (30.2%) both toxins. Most biofilm-producers (118, 93.6%), primarily weak producers (83/118, 70.3%). significantly associated with biofilm production. Conclusion C. Israel community exhibit high diversity, no dominant strain. Other may influence clinical outcomes CDI such as production, resistance Further studies are needed better understand dynamics these on CA-CDI.