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    1. Gamaleya National Research Centre for Epidemiology and Microbiology, Ministry of Public Health, Moscow, Russia
    2. I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991, Moscow, Russia

    Abstract:Clostridium diffi cile — Gram-positive microorganism and the frequent causative agent of colitis associated with the use of people with broad-spectrum antibiotics. The developing imbalance of the representatives of the normal fl ora of the large intestine promotes reproduction of the pathogen and is accompanied by the production of protein toxins - single-chain multi-domain toxins TcdA and TcdB and binary toxin CDT. After penetration of TcdA, TcdB and CDT into eukaryotic cells by receptor-mediated endocytosis, the enzymatic domains of TcdA and TcdB modify the regulatory GTPases of the Rho family by monoglucosylation, while the A-subunit of the toxin CDT ADP-ribosylated monomeric molecules, Modifi cation of target proteins leads to their inactivation and the development of a wide range of cellular disorders with signs of infl ammatory lesions of the mucous membrane of the colon. Due to the particularly important role of toxins in the pathogenesis of diff erential infection, these pathogenicity factors are considered as the main components of therapeutic, preventive and diagnostic drugs. On the other hand, the use of C. diffi cile toxins in the scientifi c search tools allows obtaining fundamental data on the mechanisms of physiological and pathological processes in eukaryotic cells.

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    Full text is published :
    Belyi Yu. F., Fialkina S. V., Troitskii V. I. Role of toxins in Clostridium diffi cile pathogenicity. Experimental and Clinical Gastroenterology. 2018;160(12): 4–10. (In Russ.) DOI: 10.31146/1682-8658-ecg-160-12-4-10
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    1. German National Reference Laboratory for Clostridium diffi cile, Germany
    2. Institute for Medical Microbiology and Hygiene, University of Saarland Medical Centre, Homburg/Saar, Germany
    3. Department for General, Visceral, Vascular, and Paediatric Surgery, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Germany
    4. Institute for Laboratory Medicine, Microbiology and Hygiene, Christophorus Kliniken, Coesfeld, Germany
    5. Institute of Hygiene, University of Münster, Münster, Germany

    Keywords: genotyping; splAST; MLST; surveillance; Russia; BI/NAP; whole genome sequencing (WGS); cgMLST

    Abstract: Clostridium diffi cile, recently renamed to Clostridioides diffi cile is the main cause of nosocomial diarrhea in developed nations. In recent years the appearance of so called “hypervirulent” strains like ribotype 027 (RT027) originating from North America has shaped the epidemiology in many parts of the world posing a huge burden on the healthcare system. These hypervirulent strains among others (e. g. RT017) are associated with resistance towards several antibiotics (e. g. fl uoroquinolones) favoring their selection. In Europe, Israel and the American continent RT027 seems to have become the most prevalent strain, while in other parts of the world other RTs dominate. In Far East Asia, RT017 is the predominant strain, while in Australia RT014/020 and RT002 are mostly prevalent. However, for most parts of the world the C. diffi cile world map is rather incomplete, such as in most African countries, Middle East Asia, South Asia but also Eastern Europe including the Russian Federation. Multi-center studies are therefore needed to assess the impact of this pathogen including its molecular epidemiology and corresponding resistance.

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    Berger F., Kuhenuri-Chami N., von Müller L., Mellmann A., Gärtner B.. Clostridium diffi cile — from Bacillus diffi cilis to Clostridioides diffi cile, global molecular epidemiology and possible implications for the Russian Federation. Experimental and Clinical Gastroenterology. 2018;160(12): 11–18. (In Russ.) DOI: 10.31146/1682-8658-ecg-160-12-11-18
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