Open AccessMultilocus Variable-Number Tandem-Repeat Analysis and Multilocus Sequence Typing Reveal Genetic Relationships among Clostridium difficile Isolates Genotyped by Restriction Endonuclease Analysis
Author(s) -
Jane W. Marsh,
Mary M. O'Leary,
Kathleen A. Shutt,
Susan P. Sambol,
Stuart Johnson,
Dale N. Gerding,
Lee H. Harrison
Publication year - 2010
Publication title -
journal of clinical microbiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.349
H-Index - 255
eISSN - 1070-633X
pISSN - 0095-1137
DOI - 10.1128/jcm.01315-09
Subject(s) - multiple loci vntr analysis , multilocus sequence typing , genotyping , biology , variable number tandem repeat , clostridium difficile , genotype , genetics , typing , molecular epidemiology , virology , gene , antibiotics
Numbers ofClostridium difficile infections have increased worldwide in the past decade. While infection withC. difficile remains predominantly a health care-associated infection, there may also be an increased incidence of community-associated infections.C. difficile strains of public health significance continue to emerge, and reliable genotyping methods for epidemiological investigations and global surveillance ofC. difficile are required. In this study, multilocus sequence typing (MLST) and multilocus variable-number tandem-repeat analysis (MLVA) were performed on a set of 157 spatially and temporally diverseC. difficile isolates that had been previously genotyped by restriction endonuclease analysis (REA) to determine the concordance among these genotyping methods. In addition, sequence analysis of thetcdC genotype was performed to investigate the association of allelic variants with epidemicC. difficile isolates. Overall, the MLST and MLVA data were concordant with REA genotyping data. MLST was less discriminatory than either MLVA or REA, yet this method establishedC. difficile genetic lineage. MLVA was highly discriminatory and demonstrated relationships among the MLST genetic lineages and REA genotypes that were previously unrecognized. SeveraltcdC genotypes were specific to epidemic clones, highlighting the possible importance of toxin misregulation inC. difficile disease pathogenesis. This study demonstrates that a combination of MLST and MLVA may prove useful for the investigation and surveillance of emergentC. difficile clones of global public health concern.