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. 2025 Jan 17;7(3):69-76.
doi: 10.46234/ccdcw2025.013.

Molecular Epidemiology of Type F Clostridium perfringens Among Diarrheal Patients and Virulence-Resistance Dynamics - 11 Provinces, China, 2024

Zelin Yan  1 , Hanyu Wang  2 , Yanyan Zhu  1 , Xuejin Wang  1   3 , Yongning Wu  4 , Yang Wang  2 , Rong Zhang  1
Affiliations

Molecular Epidemiology of Type F Clostridium perfringens Among Diarrheal Patients and Virulence-Resistance Dynamics - 11 Provinces, China, 2024

Zelin Yan et al. China CDC Wkly. .

Abstract

Introduction: Type F Clostridium perfringens (C. perfringens) represents a significant pathogen in human gastrointestinal diseases, primarily through its cpe gene encoding C. perfringens enterotoxin (CPE). This investigation examined the prevalence, antimicrobial resistance patterns, and genetic characteristics of Type F C. perfringens within the Chinese population.

Methods: The study analyzed 2,068 stool samples collected from 11 provincial hospitals in 2024. Antimicrobial susceptibility testing was conducted following Clinical & Laboratory Standards Institute (CLSI) guidelines, while whole-genome sequencing provided detailed genetic profiles. Evolutionary relationships and clonal transmission patterns were investigated through phylogenetic and genetic environment analyses.

Results: The prevalence of Type F C. perfringens was 2.38%, with isolates predominantly identified in human clinical samples and higher detection rates in gastroenterology departments. Notably, 47.1% of isolates demonstrated high resistance to metronidazole, while all exhibited intermediate resistance to erythromycin. Phylogenetic analysis revealed high similarity among isolates from patients within the same province (single-nucleotide polymorphism (SNPs)<100), and genetic environment analysis indicated potential horizontal gene transfer between animal and human strains.

Conclusions: This investigation predominantly identified Type F C. perfringens in human clinical cases, with sporadic detection in pets and food products. These findings highlight the emergence of Type F C. perfringens outbreaks among diarrheal patients, emphasizing the necessity for targeted interventions as virulence factors increase.

Keywords: Type F Clostridium perfringens; antimicrobial resistance; diarrheal patients; virulence factors.

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Conflict of interest statement

No conflicts of interest.

Figures

Figure 1
Figure 1
Distribution of antimicrobial resistance patterns among 17 F toxinotype C. perfringens isolates against 9 antimicrobial agents across 8 distinct categories.
Figure 2
Figure 2
Phylogenetic relationships and corresponding antimicrobial resistance phenotypes, virulence characteristics, and genotypic profiles of 17 C. perfringens isolates from China. Abbreviation: PLADs=provincial level administrative divisions.
Figure 3
Figure 3
Genetic organization of the cpe locus in Clostridium perfringens. Note: Arrows indicate gene orientation and function: red (toxin gene cpe), blue (mobile genetic elements), and orange (other protein-encoding genes).
Figure 4
Figure 4
Global phylogenetic analysis of 108 F type Clostridium perfringens isolates based on core genome SNPs.
See this image and copyright information in PMC

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