{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T14:03:03Z","timestamp":1782309783910,"version":"3.54.5"},"reference-count":74,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T00:00:00Z","timestamp":1696464000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"German Research Foundation (DFG, Deutsche Forschungsgemeinschaft)","doi-asserted-by":"publisher","award":["GA 546\/13-1"],"award-info":[{"award-number":["GA 546\/13-1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Clostridioides difficile is the most important pathogen causing antimicrobial-associated diarrhea and has recently been recognized as a cause of community-associated C. difficile infection (CA-CDI). This study aimed to characterize virulence factors, antimicrobial resistance (AMR), ribotype (RT) distribution and genetic relationship of C. difficile isolates from diverse fecally contaminated environmental sources. C. difficile isolates were recovered from different environmental samples in Northern Germany. Antimicrobial susceptibility testing was determined by E-test or disk diffusion method. Toxin genes (tcdA and tcdB), genes coding for binary toxins (cdtAB) and ribotyping were determined by PCR. Furthermore, 166 isolates were subjected to whole genome sequencing (WGS) for core genome multi-locus sequence typing (cgMLST) and extraction of AMR and virulence-encoding genes. Eighty-nine percent (148\/166) of isolates were toxigenic, and 51% (76\/148) were positive for cdtAB. Eighteen isolates (11%) were non-toxigenic. Thirty distinct RTs were identified. The most common RTs were RT127, RT126, RT001, RT078, and RT014. MLST identified 32 different sequence types (ST). The dominant STs were ST11, followed by ST2, ST3, and ST109. All isolates were susceptible to vancomycin and metronidazole and displayed a variable rate of resistance to moxifloxacin (14%), clarithromycin (26%) and rifampicin (2%). AMR genes, such as gyrA\/B, blaCDD-1\/2, aph(3\u2032)-llla-sat-4-ant(6)-la cassette, ermB, tet(M), tet(40), and tetA\/B(P), conferring resistance toward fluoroquinolone, beta-lactam, aminoglycoside, macrolide and tetracycline antimicrobials, were found in 166, 137, 29, 32, 21, 72, 17, and 9 isolates, respectively. Eleven \u201chypervirulent\u201d RT078 strains were detected, and several isolates belonged to RTs (i.e., RT127, RT126, RT023, RT017, RT001, RT014, RT020, and RT106) associated with CA-CDI, indicating possible transmission between humans and environmental sources pointing out to a zoonotic potential.<\/jats:p>","DOI":"10.3390\/microorganisms11102497","type":"journal-article","created":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T09:14:22Z","timestamp":1696497262000},"page":"2497","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Clostridioides\u00a0difficile from Fecally Contaminated Environmental Sources: Resistance and Genetic Relatedness from a Molecular Epidemiological Perspective"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4955-7390","authenticated-orcid":false,"given":"Khald","family":"Blau","sequence":"first","affiliation":[{"name":"Department of Microbiology\u2013Biotechnology, Faculty of Technology, University of Applied Sciences Emden\/Leer, 26723 Emden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9081-597X","authenticated-orcid":false,"given":"Fabian K.","family":"Berger","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology and Hygiene, Saarland University Medical Center, 66421 Homburg, Germany"},{"name":"German National Reference Center for Clostridioides Difficile, 66421 Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0649-5185","authenticated-orcid":false,"given":"Alexander","family":"Mellmann","sequence":"additional","affiliation":[{"name":"German National Reference Center for Clostridioides Difficile, 66421 Homburg, Germany"},{"name":"Institute of Hygiene, University of M\u00fcnster, 48149 M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8906-6756","authenticated-orcid":false,"given":"Claudia","family":"Gallert","sequence":"additional","affiliation":[{"name":"Department of Microbiology\u2013Biotechnology, Faculty of Technology, University of Applied Sciences Emden\/Leer, 26723 Emden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.jgar.2016.08.002","article-title":"Host response to Clostridium difficile infection: Diagnostics and detection","volume":"7","author":"Usacheva","year":"2016","journal-title":"J. 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