Correlation between restriction endonuclease analysis and PCR ribotyping for the identification of Clostridioides (Clostridium) difficile clinical strains

Larry K. Kociolek*, Eric R. Perdue, Warren N. Fawley, Mark H. Wilcox, Dale N. Gerding, Stuart Johnson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)


Restriction endonuclease analysis (REA) and PCR ribotyping are two typing systems that have been frequently utilized for molecular epidemiologic characterization of Clostridioides (Clostridium) difficile. To correlate typing data obtained from each method, we performed both REA and PCR ribotyping on a large and diverse set of historical and contemporary C. difficile infection clinical isolates. Eighty isolates were selected from each reference laboratory in the United States (Microbiology Reference Laboratory, Hines VA Medical Center) and United Kingdom (Clostridium difficile Network for England and Northern Ireland laboratory, University of Leeds). The 160 isolates were assigned to 82 unique ribotypes and 51 unique REA groups (116 unique REA types). In general, concordance between typing methods was good. Dendrogram analysis of PCR ribotype band patterns demonstrated close genetic relationships among strain types with discordant REA and ribotype assignments. While REA typing was more discriminatory, several REA types in this study were further discriminated by PCR ribotyping, indicating that discriminatory value of these typing methods may be strain dependent. These data will assist with molecular epidemiologic surveillance of strains identified by these two commonly used C. difficile typing systems.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
Publication statusPublished - Dec 2018
Externally publishedYes

Bibliographical note

Funding Information:
The authors acknowledge Adam Cheknis, Laurica Petrella-Zitko, and Susan Sambol for their assistance with performance of REA. D.N.G. and S.J. are both supported by the US Department of Veterans Affairs Research Service. L.K.K. is supported by a grant from the National Institute of Allergy and Infectious Diseases at the National Institutes of Health [ K23 AI123525 ].

Publisher Copyright:
© 2018 Elsevier Ltd


  • Clostridium difficile
  • Molecular epidemiology
  • PCR ribotyping
  • Restriction endonuclease analysis
  • Typing


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