近期《自然—遺傳學(xué)》公布了從全球范圍內(nèi)的衛(wèi)生保健環(huán)境中獲取的艱難梭菌（C. difficile）分離菌株匯集群的基因組測序數(shù)據(jù),。
艱難梭菌是發(fā)達(dá)國家中抗生素相關(guān)性腹瀉和衛(wèi)生保健有關(guān)感染的常見致病因素之一,。
艱難梭菌的感染以及疾病流行在過去20年有所增加,，歸其原因?yàn)楦叨拘云D難梭菌的產(chǎn)生,。
Trevor Lawley等人在全球各地搜集了151種現(xiàn)存的艱難梭菌分離菌株以及英國的145種額外的分離菌株,，并對其進(jìn)行了全基因組測序,。他們追蹤到有關(guān)艱難梭菌疾病的暴發(fā)和傳播的信息,，還發(fā)現(xiàn)其中一個(gè)菌種027/BI/NAP1包含了兩種不同的細(xì)菌世系,，與先前的只有一種細(xì)菌世系存在的研究報(bào)告不一致。
他們在論文中公布了這兩種本世紀(jì)初出現(xiàn)在北美的細(xì)菌世系,，其各自都產(chǎn)生了相同的氟喹諾酮耐藥突變,。他們認(rèn)為，這一時(shí)期氟喹諾酮抗生素的普遍使用可能產(chǎn)生了選擇性壓力,，從而導(dǎo)致了這兩種細(xì)菌世系的產(chǎn)生以及艱難梭菌流行病的出現(xiàn),。(生物谷Bioon.com)
doi:10.1038/ng.2478
PMC:
PMID:
Emergence and global spread of epidemic healthcare-associated Clostridium difficile
Miao He, Fabio Miyajima, Paul Roberts, Louise Ellison, Derek J Pickard, Melissa J Martin,Thomas R Connor, Simon R Harris, Derek Fairley, Kathleen B Bamford, Stephanie D'Arc,Jon Brazier, Derek Brown, John E Coia, Gill Douce, Dale Gerding, Hee Jung Kim, Tse Hsien Koh, Haru Kato, Mitsutoshi Senoh, Tom Louie, Stephen Michell, Emma Butt, Sharon J Peacock, Nick M Brown, Tom Riley, Glen Songer, Mark Wilcox, Munir Pirmohamed, Ed Kuijper, Peter Hawkey, Brendan W Wren, Gordon Dougan, Julian Parkhill & Trevor D Lawley
Epidemic C. difficile (027/BI/NAP1) has rapidly emerged in the past decade as the leading cause of antibiotic-associated diarrhea worldwide. However, the key events in evolutionary history leading to its emergence and the subsequent patterns of global spread remain unknown. Here, we define the global population structure of C. difficile 027/BI/NAP1 using whole-genome sequencing and phylogenetic analysis. We show that two distinct epidemic lineages, FQR1 and FQR2, not one as previously thought, emerged in North America within a relatively short period after acquiring the same fluoroquinolone resistance–conferring mutation and a highly related conjugative transposon. The two epidemic lineages showed distinct patterns of global spread, and the FQR2 lineage spread more widely, leading to healthcare-associated outbreaks in the UK, continental Europe and Australia. Our analysis identifies key genetic changes linked to the rapid transcontinental dissemination of epidemic C. difficile 027/BI/NAP1 and highlights the routes by which it spreads through the global healthcare system.
