The molecular epidemiological features of community-acquired Clostridioides difficile infection in Southwest China from 7 years of surveillance data were analyzed. Four representative C. difficile strains were selected for RNA-seq, biofilm formation, toxin expression, and cytotoxicity assays. Overall, 5.04% of the C. difficile strains were isolated within 7 years, 85.51% of which were toxigenic C. difficile (both tcdA+/tcdB+). Multilocus sequence typing (ST) and genomic sequencing divided all the isolates into two clusters, namely, clade 1 and clade 4, respectively. ST37 of C. difficile 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 C. difficile 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 C. difficile 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, C. difficile 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.
基金：
National Natural Science Foundation of China (grant No. 82360398), National Key Research and Development Program of China (grant No.2023YFC2308800), Yunnan Fundamental Research Project (grant No. 202301AT070160 and 202401AT070054), Yunnan Provincial Technological Innovation Talent Plan (grant No.202405AD350003), Support Program of Young and Middle-aged Talents in the Field of Infectious Diseases Control, and Prevention of Chinese Preventive Medicine Association
(grant No. CPMA2024CRBFK) and Infectious Disease Spectrum and Epidemiology Project of YNCDC (grant No. YNAPM2025-003).
第一作者机构：[1]Yunnan Acad Prevent Med, Inst Acute Infect Dis Control & Prevent, Yunnan Prov Ctr Dis Control & Prevent, Kunming, Peoples R China[2]Yunnan Key Lab Cross Border Infect Dis Control & P, Kunming, Peoples R China
通讯作者：
通讯机构：[4]Chinese Ctr Dis Control & Prevent, Natl Inst Communicable Dis Control & Prevent, Beijing, Peoples R China[5]Natl Key Lab Intelligent Tracking & Forecasting In, Beijing, Peoples R China
推荐引用方式(GB/T 7714)：
Gu Wenpeng,Liao Feng,Bai Lulu,et al.Changing patterns and biological features of community-acquired Clostridioides difficile infection in Southwest China: 7 years of surveillance data[J].MICROBIOLOGY SPECTRUM.2025,13(6):doi:10.1128/spectrum.02018-24.
APA：
Gu, Wenpeng,Liao, Feng,Bai, Lulu,Zhang, Wenzhu,Jia, Senquan...&Wu, Yuan.(2025).Changing patterns and biological features of community-acquired Clostridioides difficile infection in Southwest China: 7 years of surveillance data.MICROBIOLOGY SPECTRUM,13,(6)
MLA：
Gu, Wenpeng,et al."Changing patterns and biological features of community-acquired Clostridioides difficile infection in Southwest China: 7 years of surveillance data".MICROBIOLOGY SPECTRUM 13..6(2025)
