Access microbiologyPub Date : 2025-10-03eCollection Date: 2025-01-01DOI: 10.1099/acmi.0.001094.v3
Mohanned Mohamed Alwashsiah, Asma Abdellatif Abbas
{"title":"Prevalence and characterization of β-lactamase-producing bacteria in gingivitis among diabetic and non-diabetic patients: a comparative microbiological study.","authors":"Mohanned Mohamed Alwashsiah, Asma Abdellatif Abbas","doi":"10.1099/acmi.0.001094.v3","DOIUrl":"10.1099/acmi.0.001094.v3","url":null,"abstract":"<p><p><b>Background.</b> Gingivitis is a reversible gingival inflammation that may progress to periodontitis if untreated. Diabetes mellitus alters the oral microbiota and weakens host defenses, increasing susceptibility to infection. <b>Objectives.</b> To investigate the prevalence and characterization of <i>β</i>-lactamase-producing bacteria isolated from gingival swabs of diabetic and non-diabetic patients with clinically confirmed gingivitis. <b>Methods.</b> Thirty-seven patients were enrolled (17 diabetics and 20 non-diabetics). Gingival swabs were cultured and identified by conventional microbiological and analytical profile index (API). Antimicrobial susceptibility was tested according to the Clinical and Laboratory Standards Institute 2023 guidelines. <i>β</i>-Lactamase activity was assessed using an iodometric colourimetric assay. <b>Results.</b> A total of 65 bacterial isolates were obtained from 37 gingivitis patients. Polymicrobial infections predominated in diabetics (82.4%) vs. non-diabetics (45.0%). Non-diabetics were mainly colonized by <i>Streptococcus mutans</i> (45.9%) and <i>Staphylococcus aureus</i> (40.5%), while diabetics harboured more Gram-negative species, particularly <i>Pseudomonas aeruginosa</i> (21.4%) and <i>Enterobacteriaceae</i> (46.4 % vs. 2.7 %). Overall, 67.7 % of isolates were <i>β</i>-lactamase producers. Resistance was highest to ampicillin (92.3%) and amoxicillin-clavulanate (84.6%), whereas ciprofloxacin (89.2%) and piperacillin-tazobactam (78.5%) retained the greatest activity. <b>Conclusions.</b> Diabetes is associated with increased microbial diversity, Gram-negative colonization, and a frequency of <i>β</i>-lactamase-producing bacteria in gingivitis. These findings highlight diabetes as a risk factor for resistant oral infections and underscore the need for antimicrobial stewardship, resistance surveillance and future molecular studies to clarify resistance mechanisms in high-risk groups.</p>","PeriodicalId":94366,"journal":{"name":"Access microbiology","volume":"7 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Access microbiologyPub Date : 2025-10-01eCollection Date: 2025-01-01DOI: 10.1099/acmi.0.001023.v3
H Zouaki, H Laatiris, L Taoubane, A Mejjad, H Toufik, N Elouardi, A Bezza
{"title":"Articular flare-up of systemic scleroderma revealing a rare form of tuberculosis of the shoulder and extensor tendons: a case report and literature review.","authors":"H Zouaki, H Laatiris, L Taoubane, A Mejjad, H Toufik, N Elouardi, A Bezza","doi":"10.1099/acmi.0.001023.v3","DOIUrl":"10.1099/acmi.0.001023.v3","url":null,"abstract":"<p><p>Tuberculosis remains a major public health concern, particularly in countries where it is still endemic. Tuberculous bursitis and tenosynovitis are rare extrapulmonary manifestations, and their association with systemic autoimmune diseases such as scleroderma is seldom reported in the literature. We report the case of a 61-year-old patient with systemic scleroderma, complicated by diffuse interstitial lung disease and treated with mycophenolate mofetil, who developed tuberculous shoulder bursitis and wrist extensor tenosynovitis. The microbiological diagnosis was confirmed by ultrasound-guided aspiration of the subacromial-subdeltoid bursa, revealing the presence of <i>Mycobacterium tuberculosis</i>, detected by Ziehl-Neelsen staining, GeneXpert PCR and culture. Histological analysis of synovial tissue fragments demonstrated epithelioid granulomas with caseous necrosis, confirming the tuberculous origin.</p>","PeriodicalId":94366,"journal":{"name":"Access microbiology","volume":"7 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Access microbiologyPub Date : 2025-09-22eCollection Date: 2025-01-01DOI: 10.1099/acmi.0.001021.v3
Damien Farrell, Viktor Perets, Stephen V Gordon
{"title":"SNiPgenie: a tool for microbial SNP site detection from whole-genome sequencing data.","authors":"Damien Farrell, Viktor Perets, Stephen V Gordon","doi":"10.1099/acmi.0.001021.v3","DOIUrl":"10.1099/acmi.0.001021.v3","url":null,"abstract":"<p><p>Whole-genome sequencing (WGS) of microbial pathogens provides a high-resolution approach to antibiotic resistance profiling, lineage classification and outbreak surveillance. Identification of SNPs across the genome by alignment against a reference genome is the highest precision method of delineating strains. SNiPgenie is a bioinformatics pipeline designed to perform the entire variant calling process across many samples simultaneously. It was developed in the context of developing WGS tools to support the tracking of infection transmission of <i>Mycobacterium bovis</i> in livestock and wildlife, the principal causative agent of bovine tuberculosis in these populations. SNiPgenie may, however, be applied to other bacteria where evolutionary change can be tracked accurately using SNPs. The tool comes with both a command line and a user-friendly graphical interface. It can run on standard desktop or laptop computers. SNiPgenie and its documentation are available at https://github.com/dmnfarrell/snipgenie.</p>","PeriodicalId":94366,"journal":{"name":"Access microbiology","volume":"7 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Access microbiologyPub Date : 2025-09-19eCollection Date: 2025-01-01DOI: 10.1099/acmi.0.001001.v3
Saied Ali, Sinead McDermott
{"title":"In vitro activity of cefiderocol against Pseudomonas aeruginosa isolated from adult patients with cystic fibrosis.","authors":"Saied Ali, Sinead McDermott","doi":"10.1099/acmi.0.001001.v3","DOIUrl":"10.1099/acmi.0.001001.v3","url":null,"abstract":"<p><p><b>Background.</b> <i>Pseudomonas aeruginosa</i> is a key pathogen in cystic fibrosis (CF), driving pulmonary decline and exhibiting resistance through virulence factors and adaptive mutations. Cefiderocol (FDC) is a novel siderophore cephalosporin with activity against Gram-negative bacteria. We aimed to assess the <i>in vitro</i> efficacy of FDC against <i>P. aeruginosa</i> isolates in a CF population. <b>Methods.</b> The study was conducted in a tertiary hospital with a specialist adult CF service. All first isolates of significant respiratory pathogens among this cohort are cryopreserved at -80 °C. Antimicrobial susceptibility testing to FDC was performed as per European Committee on Antimicrobial Susceptibility Testing Disk-Diffusion (version 10) for all stored isolates of <i>P. aeruginosa</i> from 2017 to 2022 inclusive. <b>Results.</b> Eighty-five isolates from seventy-one patients were included. Resistance phenotypes comprised 19% (<i>n</i>=16) multidrug-resistant (MDR), 16% (<i>n</i>=14) extensively drug-resistant (XDR) and 24% (<i>n</i>=20) pandrug-resistant (PDR), with 24 % (<i>n</i>=20) exhibiting the mucoid phenotype. Overall, 85% of isolates were susceptible to FDC, with a mean inhibition zone of 25.2 mm. Antimicrobial activity was retained in 81% of MDR, 86% of XDR, 60% of PDR and 90% of mucoid isolates. Seventy-four per cent of meropenem-non-susceptible isolates remained susceptible to FDC, compared with lower susceptibility to ceftolozane-tazobactam (42%), tobramycin (36%) and ciprofloxacin (22%). <b>Conclusion.</b> FDC exhibited excellent <i>in vitro</i> activity against <i>P. aeruginosa</i> from adults with CF, including highly resistant and mucoid phenotypes. These findings highlight its potential as a salvage option in this high-risk population and provide the first Irish surveillance data to inform antimicrobial stewardship and future clinical use.</p>","PeriodicalId":94366,"journal":{"name":"Access microbiology","volume":"7 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Detection of ERG11 gene mutation in coding and non-coding regions of clinical Candida glabrata (Nakaseomyces glabratus) isolates from Pakistan.","authors":"Saba Memon, Najia Karim Ghanchi, Urooj Zafar, Joveria Farooqi, Sadaf Zaka, Kauser Jabeen","doi":"10.1099/acmi.0.000952.v6","DOIUrl":"10.1099/acmi.0.000952.v6","url":null,"abstract":"<p><p>Azoles inhibit the cytochrome P450-dependent enzyme lanosterol 14α-demethylase (<i>CYP51</i>) that is encoded by the <i>ERG11</i> gene. Azole resistance in <i>Candida</i> species arises through different mechanisms, like mutations in the <i>ERG11</i> gene, <i>ERG11</i> overexpression, CDR1,2 (<i>Candida</i> drug resistance) overexpression that actively efflux azole drugs, reducing their intracellular concentration and therapeutic effectiveness, and biofilm formation. We sequenced the <i>ERG11</i> gene to determine mutations in the coding and non-coding regions of <i>ERG11</i> in clinical isolates of <i>Candida glabrata</i> (<i>Nakaseomyces glabratus</i>) from Pakistan. Eight <i>C. glabrata</i> (<i>N. glabratus</i>) strains from our fungal strain bank (five fluconazole-resistant and three susceptible dose-dependent) were revived and used. The <i>ERG11</i> gene was amplified by PCR, sequenced using the Sanger methodology and analysed using bioinformatic tools. We identified a change in nucleotide at c. -66 T/G upstream of the start codon ATG in the promoter region of the <i>ERG11</i> gene in fluconazole-resistant <i>C. glabrata</i> (<i>N. glabratus</i>). Within the downstream (coding region), where numbering begins at the ATG start codon as position +1, two novel synonymous mutations at positions T300C and T834C and previously reported synonymous mutations T768C, A1023G, T1557A and A1581G were also observed. This is the first study evaluating <i>ERG11</i> mutations in <i>C. glabrata</i> (<i>N. glabratus</i>) from Pakistan. The clinical significance of such uncommon <i>ERG11</i> gene mutations, such as c. -66 T/G, should be explored further through correlation with treatment outcome data.</p>","PeriodicalId":94366,"journal":{"name":"Access microbiology","volume":"7 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A novel case of prosthetic joint infection due to Clostridioides difficile successfully suppressed with oral doxycycline.","authors":"Holly Jordan, Rikki Graham, Sanmarie Schlebusch, Aileen Oon, Hemalatha Varadhan, Syeda Naqvi","doi":"10.1099/acmi.0.000943.v3","DOIUrl":"10.1099/acmi.0.000943.v3","url":null,"abstract":"<p><p>Extra-colonic infections caused by <i>Clostridioides difficile</i> are exceptionally rare, with prosthetic joint infections (PJIs) comprising only a small fraction of the reported cases. Moreover, there is limited guidance on the optimal management of such infections. We present the case of a 76-year-old man who developed a left hip PJI due to <i>C. difficile</i> 6 weeks after undergoing surgical revision for a periprosthetic fracture. Given the complexity of the case, curative surgical intervention was not considered feasible. The patient was treated with repeated debridement, intravenous vancomycin and oral (PO) metronidazole, followed by successful suppression with PO doxycycline - a novel therapeutic approach not previously documented. To date, only seven cases of <i>C. difficile</i>-associated PJI have been reported in the literature; this is the first known instance in which suppression of a <i>C. difficile</i> PJI has been achieved and the first to utilize whole-genome sequencing for further analysis of the isolate.</p>","PeriodicalId":94366,"journal":{"name":"Access microbiology","volume":"7 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluation of the efficacy of chlorous acid water and sodium hypochlorite solution against SARS-CoV-2 in the presence of organic matter.","authors":"Basirat Mojisola Lawal-Ayinde, Kosuke Oda, Abeer Mohamed Abdelfattah Elsayed, Tomoyuki Akita, Miuko Kurose, Hiroaki Sasaki, Toshihito Nomura, Akima Yamamoto, Akifumi Higashiura, Isanori Horiuchi, Hisataka Goda, Takemasa Sakaguchi","doi":"10.1099/acmi.0.000984.v3","DOIUrl":"10.1099/acmi.0.000984.v3","url":null,"abstract":"<p><p>Chlorous acid water and sodium hypochlorite solution are effective disinfectants against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the virus that caused the pandemic. Recent studies have shown that both compounds have equivalent inactivation effects when tested on purified viruses. However, in practical applications, the presence of organic matter is common and can significantly affect disinfectant performance. We conducted several experiments comparing these two disinfectants under different conditions to better understand their practical efficacy. When an infected cell culture medium (serum-free) was used as the test virus, chlorous acid water and sodium hypochlorite solution showed reduced efficacy. This decrease was attributed to the presence of aa in the medium. Notably, sodium hypochlorite solution showed a more pronounced reduction in potency compared with chlorous acid water. In addition, we evaluated the SARS-CoV-2 inactivation effects of chlorous acid water and sodium hypochlorite solution under various organic loading conditions simulating real-world contamination scenarios such as blood, vomit and saliva. The organic materials used included BSA, SRBCs, polypeptone, FBS and artificial saliva. The results showed that chlorous acid water demonstrated superior resilience to organic matter interference compared with sodium hypochlorite solution. These results suggest that chlorous acid water may be more effective than sodium hypochlorite solution in inactivating viruses on contaminated surfaces, particularly in healthcare settings where organic contamination is common. In summary, our research suggests that chlorous acid water may be a more effective disinfectant in practical settings.</p>","PeriodicalId":94366,"journal":{"name":"Access microbiology","volume":"7 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Access microbiologyPub Date : 2025-09-17eCollection Date: 2025-01-01DOI: 10.1099/acmi.0.001019.v3
Ilhan Cem Duru, Zlatka Plavec, Anne Ylinen, Pia Laine, Martyn James, Lotta Riihimäki, Sarah J Butcher, Maria Anastasina, Petri Auvinen
{"title":"Direct RNA sequencing reveals m6A modifications and isoform changes in SARS-CoV-2-infected HEK cells.","authors":"Ilhan Cem Duru, Zlatka Plavec, Anne Ylinen, Pia Laine, Martyn James, Lotta Riihimäki, Sarah J Butcher, Maria Anastasina, Petri Auvinen","doi":"10.1099/acmi.0.001019.v3","DOIUrl":"10.1099/acmi.0.001019.v3","url":null,"abstract":"<p><p>The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection triggers complex host responses, including alterations in RNA transcription and modification. Understanding these changes is crucial for elucidating viral pathogenesis and identifying potential therapeutic targets. We used direct RNA sequencing to comprehensively profile the transcriptomic and epitranscriptomic landscapes of human HEK-AT cells infected with SARS-CoV-2 at 8 h post-infection, compared to mock controls. We analysed viral and host transcriptomes, focusing on gene and transcript expression, isoform usage and RNA m6A modifications. Viral RNA sequencing reads showed 3' end-biassed coverage indicative of subgenomic RNA synthesis, with high expression of <i>N</i> gene subgenomic RNA reads. Sixteen m6A modification sites were consistently identified in the viral genome, primarily within the <i>ORF1ab</i> and <i>S</i> genes. In the human transcriptome, we found 254 positions with significantly altered m6A modification rates, with 119 showing decreased modification and 135 showing increased modification in infected cells. Genes with decreased m6A modifications were enriched in the neurotrophin signalling pathway. Transcript-level analysis identified 19 upregulated and 12 downregulated transcripts. Notably, transcript discovery and quantification revealed a novel isoform of the <i>HIST1H2BK</i> gene, which was significantly more expressed in infected cells compared to mock controls. Isoform switching analysis revealed 24 significant switches involving 21 genes, implicating mitochondrial reprogramming and immune-related pathways. In conclusion, this study provides a detailed, direct RNA sequencing-based characterization of host-virus RNA interactions, revealing key insights into SARS-CoV-2 infection mechanisms and potential therapeutic targets.</p>","PeriodicalId":94366,"journal":{"name":"Access microbiology","volume":"7 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Access microbiologyPub Date : 2025-09-10eCollection Date: 2025-01-01DOI: 10.1099/acmi.0.000781.v4
Yassine Ben Lahlou, Zakaria Laanibi, Zakaria Malihy, Elmostapha Benaissa, Adil Maleb, Abderrahim Elktaibi, Mariama Chadli, Mostafa Elouennass
{"title":"A hydrocele revealing epididymal tuberculosis.","authors":"Yassine Ben Lahlou, Zakaria Laanibi, Zakaria Malihy, Elmostapha Benaissa, Adil Maleb, Abderrahim Elktaibi, Mariama Chadli, Mostafa Elouennass","doi":"10.1099/acmi.0.000781.v4","DOIUrl":"10.1099/acmi.0.000781.v4","url":null,"abstract":"<p><p>Genitourinary tuberculosis is a severe form of extrapulmonary tuberculosis. The kidneys are the most commonly affected organs, followed by the epididymis, testicles, bladder, ureter and prostate. Notably, epididymal tuberculosis is one of the forms of genital tuberculosis presenting with specific clinical features, which may include epididymitis, orchid-epididymitis or hydrocele. We report the case of a patient with a hydrocele that revealed epididymal tuberculosis. Utilizing molecular biology techniques, a diagnostic test for epididymal tuberculosis was established. The patient was treated conservatively with tuberculosis medication for 6 months.</p>","PeriodicalId":94366,"journal":{"name":"Access microbiology","volume":"7 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Access microbiologyPub Date : 2025-09-10eCollection Date: 2025-01-01DOI: 10.1099/acmi.0.000994.v3
Adriana Badilla-Lobo, Carlos Quesada-Gómez, Esteban Chaves-Olarte, César Rodríguez
{"title":"Allele-linked divergence in SlpA and TcdB drives distinct immune and cytotoxic responses that distinguish ST01 from non-ST01 strains in Clade 2 Clostridioides difficile.","authors":"Adriana Badilla-Lobo, Carlos Quesada-Gómez, Esteban Chaves-Olarte, César Rodríguez","doi":"10.1099/acmi.0.000994.v3","DOIUrl":"10.1099/acmi.0.000994.v3","url":null,"abstract":"<p><p>Among the five MLST clades that define the global population structure of the bacterial pathogen <i>Clostridioides difficile</i>, Clade 2 has received special attention due to the global spread, clinical severity and hospital prevalence of ST01 strains. To identify features potentially contributing to the historically attributed higher virulence and epidemic potential of ST01 strains, we compared a range of phenotypic traits across the infection cycle between clinical Clade 2 ST01 and non-ST01 strains from ST41, ST47, ST67, ST154 and ST638. We found no significant differences in canonical virulence-associated characteristics such as spore adherence, motility, biofilm formation and resistance to a disinfectant. However, ST01 strains exhibited distinct profiles in surface layer protein A (SlpA)-mediated immune activation and toxin B (TcdB)-induced cytotoxicity that were consistent with allelic divergence. These findings highlight the need to reconsider current paradigms of Clade 2 hypervirulence and underscore the importance of allele-specific phenotypic variation in developing targeted public health strategies.</p>","PeriodicalId":94366,"journal":{"name":"Access microbiology","volume":"7 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}