Title |
Mechanisms of hypervirulent Clostridium difficile ribotype 027 displacement of endemic strains: an epidemiological model
|
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Published in |
Scientific Reports, July 2015
|
DOI | 10.1038/srep12666 |
Pubmed ID | |
Authors |
Laith Yakob, Thomas V. Riley, David L. Paterson, John Marquess, Ricardo J. Soares Magalhaes, Luis Furuya-Kanamori, Archie C.A. Clements |
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. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 1 | 25% |
United States | 1 | 25% |
Unknown | 2 | 50% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 3 | 75% |
Practitioners (doctors, other healthcare professionals) | 1 | 25% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Ireland | 1 | 1% |
Unknown | 93 | 99% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 16 | 17% |
Student > Master | 15 | 16% |
Student > Bachelor | 15 | 16% |
Student > Ph. D. Student | 13 | 14% |
Professor | 5 | 5% |
Other | 15 | 16% |
Unknown | 15 | 16% |
Readers by discipline | Count | As % |
---|---|---|
Agricultural and Biological Sciences | 20 | 21% |
Immunology and Microbiology | 16 | 17% |
Biochemistry, Genetics and Molecular Biology | 11 | 12% |
Medicine and Dentistry | 10 | 11% |
Pharmacology, Toxicology and Pharmaceutical Science | 4 | 4% |
Other | 15 | 16% |
Unknown | 18 | 19% |