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Volume 14, Number 9—September 2008

Letter

Clindamycin-Resistant Clone of Clostridium difficile PCR Ribotype 027, Europe

Denise DrudyComments to Author , Bram Goorhuis, Dennis Bakker, Lorraine Kyne, Renate van den Berg, Lynda Fenelon, Seamus Fanning, and Edward J. Kuijper
Author affiliations: University College Dublin, Dublin, Ireland (D. Drudy, L. Kyne, L. Fenelon, S. Fanning); Leiden University Medical Center, Leiden, the Netherlands (B. Goorhuis, D. Bakker, R. van den Berg, E.J. Kuijper); European Centre for Disease Prevention and Control, Stockholm, Sweden (E.J. Kuijper);

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Figure

Minimal spanning tree of 23 Clostridium difficile isolates. In the circles, the individual isolates are mentioned. The numbers between the circles represent the summed tandem repeat differences (STRDs) between multiple-locus variable-number tandem-repeat analysis types. Straight lines represent single-locus variants, dashed lines double-locus variants. Curved lines represent triple-locus variants. Two related clusters can be discriminated: the light gray cluster (isolates B1, B4, M246, B6, and M216) and the cluster within dotted lines (isolates V6–44, V6–142, V6–81, 1ML, C1, 4108, V6–35, V6–80, L1, 2191cc, C4, C8, 3ML, C44, C37, and 13ML) The isolates in the light gray cluster are sensitive to clindamycin; isolates in the cluster surrounded by dashed lines are resistant. Two isolates (M278 and R20291) did not belong to a cluster but were more related to the sensitive cluster than to the resistant cluster. Genetically related clusters were defined by an STRD <10.

Figure. Minimal spanning tree of 23 Clostridium difficile isolates. In the circles, the individual isolates are mentioned. The numbers between the circles represent the summed tandem repeat differences (STRDs) between multiple-locus variable-number tandem-repeat analysis types. Straight lines represent single-locus variants, dashed lines double-locus variants. Curved lines represent triple-locus variants. Two related clusters can be discriminated: the light gray cluster (isolates B1, B4, M246, B6, and M216) and the cluster within dotted lines (isolates V6–44, V6–142, V6–81, 1ML, C1, 4108, V6–35, V6–80, L1, 2191cc, C4, C8, 3ML, C44, C37, and 13ML) The isolates in the light gray cluster are sensitive to clindamycin; isolates in the cluster surrounded by dashed lines are resistant. Two isolates (M278 and R20291) did not belong to a cluster but were more related to the sensitive cluster than to the resistant cluster. Genetically related clusters were defined by an STRD <10.

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