{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:11:04Z","timestamp":1785409864590,"version":"3.56.0"},"reference-count":45,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100001809","name":"MOST | National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82360398"],"award-info":[{"award-number":["82360398"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"MOST | National Key Research and Development Program of China","award":["2023YFC2308800"],"award-info":[{"award-number":["2023YFC2308800"]}]},{"name":"Yunnan Fundamental Research Project","award":["202301AT070160 and 202401AT070054"],"award-info":[{"award-number":["202301AT070160 and 202401AT070054"]}]},{"name":"Yunnan Provincial Technological Innovation Talent Plan","award":["202405AD350003"],"award-info":[{"award-number":["202405AD350003"]}]},{"name":"Support Program of Young and Middle-aged Talents in the Field of Infectious Diseases Control and Prevention of Chinese Preventive Medicine Association","award":["CPMA2024CRBFK"],"award-info":[{"award-number":["CPMA2024CRBFK"]}]},{"name":"Infectious Disease Spectrum and Epidemiology Project of YNCDC","award":["YNAPM2025-003"],"award-info":[{"award-number":["YNAPM2025-003"]}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2025,6,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      The molecular epidemiological features of community-acquired\n                      <jats:italic toggle=\"yes\">Clostridioides difficile<\/jats:italic>\n                      infection in Southwest China from 7 years of surveillance data were analyzed. Four representative\n                      <jats:italic toggle=\"yes\">C. difficile<\/jats:italic>\n                      strains were selected for RNA-seq, biofilm formation, toxin expression, and cytotoxicity assays. Overall, 5.04% of the\n                      <jats:italic toggle=\"yes\">C. difficile<\/jats:italic>\n                      strains were isolated within 7 years, 85.51% of which were toxigenic\n                      <jats:italic toggle=\"yes\">C. difficile<\/jats:italic>\n                      (both\n                      <jats:italic toggle=\"yes\">tcdA<\/jats:italic>\n                      +\/\n                      <jats:italic toggle=\"yes\">tcdB<\/jats:italic>\n                      +). Multilocus sequence typing (ST) and genomic sequencing divided all the isolates into two clusters, namely, clade 1 and clade 4, respectively. ST37 of\n                      <jats:italic toggle=\"yes\">C. difficile<\/jats:italic>\n                      gradually replaced the ST3, ST35, and ST54 genotypes and became the dominant genotype in this area. The antibiotic resistance rate of strains in clade 4 was higher than that in clade 1, especially for the ST37 genotype strains, which were resistant to quinolones. Four\n                      <jats:italic toggle=\"yes\">C. difficile<\/jats:italic>\n                      strains, R20291 (RT027), CD21062 (RT078), CD279 (ST54), and CD413 (ST37), were selected as representative isolates for subsequent biological investigations. RNA-seq revealed that the DEGs of\n                      <jats:italic toggle=\"yes\">C. difficile<\/jats:italic>\n                      ST54 were enriched mainly in ABC transporters, two-component systems, and quorum sensing (QS) pathways and exhibited strong biofilm formation ability. The DEGs of the ST37 genotype strains were mainly enriched in the phosphotransferase system (PTS), ribosome, and some sugar and amino acid metabolism pathways, suggesting that these isolates have increased proliferation and metabolic status. On the other hand,\n                      <jats:italic toggle=\"yes\">C. difficile<\/jats:italic>\n                      R20291 had the highest level of toxin transcription, expression, and cytotoxicity among these four strains. These genotype strains had their own biological characteristics, which provided certain clues for analyzing the causes of these changes.\n                    <\/jats:p>\n                    <jats:sec>\n                      <jats:title>IMPORTANCE<\/jats:title>\n                      <jats:p>\n                        This study carried out a molecular epidemiological investigation of community-acquired\n                        <jats:italic toggle=\"yes\">C. difficile<\/jats:italic>\n                        infection in Southwest China and revealed the characteristics of genotype pattern changes in the strains.\n                        <jats:italic toggle=\"yes\">C. difficile<\/jats:italic>\n                        ST37 gradually replaced the ST3, ST35, and ST54 genotypes to become the dominant strains in this area. Moreover, some representative strains were used to study their biological features. The ST54 strain had strong biofilm formation ability, and ABC transporters, two-component systems, and quorum sensing pathways were enriched according to RNA-seq. The ST37 genotype strain was enriched in the PTS, ribosome, and several sugar and amino acid metabolism pathways. The antibiotic resistance rate of Clade 4\n                        <jats:italic toggle=\"yes\">C<\/jats:italic>\n                        .\n                        <jats:italic toggle=\"yes\">difficile<\/jats:italic>\n                        was higher than that of clade 1 strains, especially for the resistance of\n                        <jats:italic toggle=\"yes\">C. difficile<\/jats:italic>\n                        ST37 to quinolones. The biological characteristics of these representative strains might provide certain clues for investigating the reasons for these changes.\n                      <\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.02018-24","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T21:08:54Z","timestamp":1746047334000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":3,"title":["Changing patterns and biological features of community-acquired\n                    <i>Clostridioides difficile<\/i>\n                    infection in Southwest China: 7 years of surveillance data"],"prefix":"10.1128","volume":"13","author":[{"given":"Wenpeng","family":"Gu","sequence":"first","affiliation":[{"name":"Institute of Acute Infectious Diseases Control and Prevention, Yunnan Provincial Center for Disease Control and Prevention (Yunnan Academy of 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