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- Title
Mechanisms of hypervirulent Clostridium difficile ribotype 027 displacement of endemic strains: an epidemiological model.
- Authors
Yakob, Laith; Riley, Thomas V.; Paterson, David L.; Marquess, John; Magalhaes, Ricardo J. Soares; Furuya-Kanamori, Luis; Clements, Archie C.A.
- Abstract
Following rapid, global clonal dominance of hypervirulent ribotypes, Clostridium difficile now constitutes the primary infectious cause of nosocomial diarrhoea. Evidence indicates at least three possible mechanisms of hypervirulence that facilitates the successful invasion of these atypical strains: 1) increased infectiousness relative to endemic strains; 2) increased symptomatic disease rate relative to endemic strains; and 3) an ability to outcompete endemic strains in the host's gut. Stochastic simulations of an infection transmission model demonstrate clear differences between the invasion potentials of C. difficile strains utilising the alternative hypervirulence mechanisms, and provide new evidence that favours certain mechanisms (1 and 2) more than others (3). Additionally, simulations illustrate that direct competition between strains (inside the host's gut) is not a prerequisite for the sudden switching that has been observed in prevailing ribotypes; previously dominant C. difficile strains can be excluded by hypervirulent ribotypes through indirect (exploitative) competition.
- Subjects
CLOSTRIDIOIDES difficile; EPIDEMIOLOGICAL models; STOCHASTIC analysis; SIMULATION methods &; models; BACILLACEAE
- Publication
Scientific Reports, 2015, p12666
- ISSN
2045-2322
- Publication type
Article
- DOI
10.1038/srep12666