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The prevalence and subtype (ST) characteristics of <jats:italic>Blastocystis<\/jats:italic> in patients with <jats:italic>C. difficile<\/jats:italic> infection (CDI) are rarely documented. Therefore, the present study was conducted to investigate the prevalence and subtype characteristics of <jats:italic>Blastocystis<\/jats:italic> in patients with suspicion of CDI in Singapore.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Fecal samples were collected from 248 patients presenting with suspected CDI from a single tertiary hospital in Singapore. <jats:italic>C. difficile<\/jats:italic> was diagnosed through positive glutamate dehydrogenase (GDH) with or without toxin A\/B using enzyme immunoassay methods. The prevalence and subtype genetic characteristics of <jats:italic>Blastocystis<\/jats:italic> were determined by polymerase chain reaction (PCR) amplification and analysis of the barcode region of the <jats:italic>SSU<\/jats:italic> rRNA gene.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The proportion of <jats:italic>C. difficile<\/jats:italic> in patients with healthcare-associated diarrhea in this study was 44% (109\/248). Among the 109 <jats:italic>C. difficile<\/jats:italic>-positive patients, 59 (54.1%, 59\/109) tested positive for toxigenic <jats:italic>C. difficile<\/jats:italic>, which was considered CDI. Based on the sequence analyses of the barcode region of the <jats:italic>SSU<\/jats:italic> rRNA gene, 10.1% (25\/248) of the patients were found to be <jats:italic>Blastocystis<\/jats:italic>-positive, and three subtypes were identified: ST7 (64%, 16\/25), ST1 (20%, 5\/25), and ST3 (16%, 4\/25). Remarkably, we found five patients with <jats:italic>Blastocystis<\/jats:italic> and <jats:italic>C. difficile<\/jats:italic> coinfection, and further subtype analysis showed two with ST7, two with ST1, and one with ST3.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>To the best of our knowledge, this is the first study to investigate the subtype distributions of <jats:italic>Blastocystis<\/jats:italic> in patients with CDI in Singapore. We found ST7 to be the predominant subtype in diarrheal patients. The pathogenicity of ST7 has been strongly suggested in previous in vitro and mouse model experiments, further confirming its potential pathogenicity to humans.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical Abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1186\/s13071-021-04749-8","type":"journal-article","created":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T08:02:52Z","timestamp":1621843372000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Prevalence and molecular subtyping of Blastocystis in patients with Clostridium difficile infection, Singapore"],"prefix":"10.1186","volume":"14","author":[{"given":"Lei","family":"Deng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiyi","family":"Tay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangneng","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan W. 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Clin Infect Dis. 2020;71:2630\u20136.","journal-title":"Clin Infect Dis"}],"container-title":["Parasites &amp; Vectors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13071-021-04749-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13071-021-04749-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13071-021-04749-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,2]],"date-time":"2023-02-02T16:11:56Z","timestamp":1675354316000},"score":1,"resource":{"primary":{"URL":"https:\/\/parasitesandvectors.biomedcentral.com\/articles\/10.1186\/s13071-021-04749-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,24]]},"references-count":51,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["4749"],"URL":"https:\/\/doi.org\/10.1186\/s13071-021-04749-8","relation":{},"ISSN":["1756-3305"],"issn-type":[{"value":"1756-3305","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,24]]},"assertion":[{"value":"6 January 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 April 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 May 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the National Healthcare Group Domain Specific Review Board (NHG DSRB) (reference number: 2017\/01110). Written informed consent was obtained from the patients before collecting the fecal samples.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"277"}}