[Nature Genetics]Emergence and global spread of epidemic HA-CD
Emergence and global spread of epidemic healthcare-associated Clostridium difficile[*]Miao He,1
[*]Fabio Miyajima,2, 3
[*]Paul Roberts,2, 3
[*]Louise Ellison,1
[*]Derek J Pickard,1
[*]Melissa J Martin,4
[*]Thomas R Connor,1
[*]Simon R Harris,1
[*]Derek Fairley,5
[*]Kathleen B Bamford,6, 7
[*]Stephanie D'Arc,6, 7
[*]Jon Brazier,8
[*]Derek Brown,9
[*]John E Coia,9
[*]Gill Douce,9
[*]Dale Gerding,10
[*]Hee Jung Kim,11
[*]Tse Hsien Koh,12
[*]Haru Kato,13
[*]Mitsutoshi Senoh,13
[*]Tom Louie,14
[*]Stephen Michell,15
[*]Emma Butt,15
[*]Sharon J Peacock,1, 16, 17, 18
[*]Nick M Brown,17, 18
[*]Tom Riley,19
[*]Glen Songer,20
[*]Mark Wilcox,21
[*]Munir Pirmohamed,2, 3
[*]Ed Kuijper,22
[*]Peter Hawkey,23
[*]Brendan W Wren,4
[*]Gordon Dougan,1
[*]Julian Parkhill1
[*]& Trevor D Lawley1
[*]et al.
[*]Affiliations
[*]Contributions
[*]Corresponding authors
Journal name: Nature Genetics Year published: (2012) DOI: doi:10.1038/ng.2478Received 03 May 2012Accepted 01 November 2012 Published online 09 December 2012
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.
NG，30分的杂志，较少报道MDRO相关论文。近年来NG关注GWAS较多，今天中午午休时间，惊喜的在其这期杂志上面看到了关于CD的报道。从论文的表达，目前医疗相关艰难梭菌感染已经成为一个不容忽视的问题了。 这是文中的两张图。上传给大家分享一下。 感谢南鱼的分享，非常惊喜，NG也关注MDRO了。 芝加哥大学和我们的合作也是关于艰难梭菌感染的，国内关于这一块的研究几乎很少呢，近几年国外很热。
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