a School of Biomedical Sciences , The University of Western Australia , Crawley, Australia.
b Department of Microbiology, Faculty of Medicine Siriraj Hospital , Mahidol University , Bangkok, Thailand.
Emerg Microbes Infect. 2019;8(1):796-807. doi: 10.1080/22221751.2019.1621670.
ribotype (RT) 017 is an important toxigenic RT which, due to a deletion in the repetitive region of the gene, only produces functional toxin B. Strains belonging to this RT were initially dismissed as nonpathogenic and circulated largely undetected for almost two decades until they rose to prominence following a series of outbreaks in the early 2000s. Despite lacking a functional toxin A, RT 017 strains have been shown subsequently to be capable of causing disease as severe as that caused by strains producing both toxins A and B. While RT 017 strains can be found in almost every continent today, epidemiological studies suggest that the RT is endemic in Asia and that the global spread of this MLST clade 4 lineage member is a relatively recent event. RT 017 transmission appears to be mostly from human to human with only a handful of reports of isolations from animals. An important feature of RT 017 strains is their resistance to several antimicrobials and this has been documented as a possible factor driving multiple outbreaks in different parts of the world. This review summarizes what is currently known regarding the emergence and evolution of strains belonging to RT 017 as well as features that have allowed it to become an RT of global importance.
ribotype (RT) 017 是一种重要的产毒 RT，由于基因重复区的缺失，它仅产生功能性毒素 B。属于该 RT 的菌株最初被认为是无致病性的，在近二十年的时间里，它们几乎没有被发现，直到 21 世纪初一系列疫情爆发后才引起关注。尽管缺乏功能性毒素 A，但后来发现 RT 017 菌株能够引起与产生毒素 A 和 B 的菌株一样严重的疾病。虽然 RT 017 菌株如今几乎在各大洲都有发现，但流行病学研究表明，该 RT 在亚洲流行，该 MLST 克隆 4 谱系成员在全球的传播是相对较新的事件。RT 017 的传播似乎主要是人与人之间的传播，仅有少数几例从动物中分离的报道。RT 017 菌株的一个重要特征是对几种抗生素的耐药性，这被认为是导致世界各地多次爆发的一个可能因素。本文总结了目前关于属于 RT 017 的菌株的出现和进化以及使其成为具有全球重要性的 RT 的特征的相关知识。
