The Clostridium difficile PCR ribotype 027 lineage: a pathogen on the move

Clin Microbiol Infect. 2014 May;20(5):396-404. doi: 10.1111/1469-0691.12619. Epub 2014 Apr 28.


Clostridium difficile is a Gram-positive, spore-forming, human and animal pathogen that is the major cause of antibiotic-associated diarrhoea worldwide. The past decade has seen the rapid emergence of the hypervirulent PCR ribotype (RT) 027 complex, which has been associated with increases in the incidence and severity of disease and mortality. In this review, we describe the potential virulence factors that have been reported in strains from the RT 027 complex. We review the emergence, population structure, dissemination and evolution of this lineage.

Keywords: Clostridium difficile; PCR RT 027; dissemination; evolution; genome analysis; pathogen.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Clostridium difficile / genetics*
  • Clostridium difficile / pathogenicity*
  • Communicable Diseases, Emerging / genetics*
  • Enterocolitis, Pseudomembranous / epidemiology*
  • Enterocolitis, Pseudomembranous / microbiology
  • Enterotoxins / genetics
  • Enterotoxins / metabolism
  • Evolution, Molecular
  • Genome, Bacterial
  • Humans
  • Phylogeny
  • Phylogeography
  • Ribotyping*
  • Virulence Factors / genetics*


  • Enterotoxins
  • Virulence Factors