Key publications
Francis VI, Stevenson EC, Porter SL (2017). Two-component systems required for virulence in Pseudomonas aeruginosa.
FEMS Microbiology Letters,
364 Full text.
Stevenson EC, Major GA, Spiller RC, Kuehne SA, Minton NP (2016). Coinfection and emergence of rifamycin resistance during a recurrent clostridium difficile infection.
Journal of Clinical Microbiology,
54(11), 2689-2694.
Abstract:
Coinfection and emergence of rifamycin resistance during a recurrent clostridium difficile infection
Copyright © 2016, American Society for Microbiology. All Rights Reserved. Clostridium difficile (Peptoclostridium difficile) is a common health care-associated infection with a disproportionately high incidence in elderly patients. Disease symptoms range from mild diarrhea to life-threatening pseudomembranous colitis. Around 20% of patients may suffer recurrent disease, which often requires rehospitalization of patients. C. difficile was isolated from stool samples from a patient with two recurrent C. difficile infections. PCR ribotyping, whole-genome sequencing, and phenotypic assays were used to characterize these isolates. Genotypic and phenotypic screening of C. difficile isolates revealed multiple PCR ribotypes present and the emergence of rifamycin resistance during the infection cycle. Understanding both the clinical and bacterial factors that contribute to the course of recurrent infection could inform strategies to reduce recurrence.
Abstract.
Stevenson E, Minton NP, Kuehne SA (2015). The role of flagella in Clostridium difficile pathogenicity. Trends in Microbiology, 23(5), 275-282.
Lister M, Stevenson E, Heeg D, Minton NP, Kuehne SA (2014). Comparison of culture based methods for the isolation of Clostridium difficile from stool samples in a research setting. Anaerobe, 28, 226-229.
Butt E, Foster JAH, Keedwell E, Bell JEA, Titball RW, Bhangu A, Michell SL, Sheridan R (2013). Derivation and validation of a simple, accurate and robust prediction rule for risk of mortality in patients with Clostridium difficile infection.
BMC Infect Dis,
13Abstract:
Derivation and validation of a simple, accurate and robust prediction rule for risk of mortality in patients with Clostridium difficile infection.
BACKGROUND: Clostridium difficile infection poses a significant healthcare burden. However, the derivation of a simple, evidence based prediction rule to assist patient management has not yet been described. METHOD: Univariate, multivariate and decision tree procedures were used to deduce a prediction rule from over 186 variables; retrospectively collated from clinical data for 213 patients. The resulting prediction rule was validated on independent data from a cohort of 158 patients described by Bhangu et al. (Colorectal Disease, 12(3):241-246, 2010). RESULTS: Serum albumin levels (g/L) (P = 0.001), respiratory rate (resps /min) (P = 0.002), C-reactive protein (mg/L) (P = 0.034) and white cell count (mcL) (P = 0.049) were predictors of all-cause mortality. Threshold levels of serum albumin ≤ 24.5 g/L, C- reactive protein >228 mg/L, respiratory rate >17 resps/min and white cell count >12 × 10(3) mcL were associated with an increased risk of all-cause mortality. A simple four variable prediction rule was devised based on these threshold levels and when tested on the initial data, yield an area under the curve score of 0.754 (P
Abstract.
Author URL.
Full text.
He M, Miyajima F, Roberts P, Ellison L, Pickard DJ, Martin MJ, Connor TR, Harris SR, Fairley D, Bamford KB, et al (2013). Emergence and global spread of epidemic healthcare-associated Clostridium difficile.
Nature Genetics,
45(1), 109-113.
Abstract:
Emergence and global spread of epidemic healthcare-associated Clostridium difficile
Epidemic C. difficile (027/BI/NAP1) has rapidly emerged in the past decade as the leading cause of antibiotic-associated diarrhea worldwide. However, the key events in evolutionary history leading to its emergence and the subsequent patterns of global spread remain unknown. Here, we define the global population structure of C. difficile 027/BI/NAP1 using whole-genome sequencing and phylogenetic analysis. We show that two distinct epidemic lineages, FQR1 and FQR2, not one as previously thought, emerged in North America within a relatively short period after acquiring the same fluoroquinolone resistance-conferring mutation and a highly related conjugative transposon. The two epidemic lineages showed distinct patterns of global spread, and the FQR2 lineage spread more widely, leading to healthcare-associated outbreaks in the UK, continental Europe and Australia. Our analysis identifies key genetic changes linked to the rapid transcontinental dissemination of epidemic C. difficile 027/BI/NAP1 and highlights the routes by which it spreads through the global healthcare system. © 2013 Nature America, Inc. All rights reserved.
Abstract.
Publications by category
Journal articles
Francis VI, Stevenson EC, Porter SL (2017). Two-component systems required for virulence in Pseudomonas aeruginosa.
FEMS Microbiology Letters,
364 Full text.
Stevenson EC, Major GA, Spiller RC, Kuehne SA, Minton NP (2016). Coinfection and emergence of rifamycin resistance during a recurrent clostridium difficile infection.
Journal of Clinical Microbiology,
54(11), 2689-2694.
Abstract:
Coinfection and emergence of rifamycin resistance during a recurrent clostridium difficile infection
Copyright © 2016, American Society for Microbiology. All Rights Reserved. Clostridium difficile (Peptoclostridium difficile) is a common health care-associated infection with a disproportionately high incidence in elderly patients. Disease symptoms range from mild diarrhea to life-threatening pseudomembranous colitis. Around 20% of patients may suffer recurrent disease, which often requires rehospitalization of patients. C. difficile was isolated from stool samples from a patient with two recurrent C. difficile infections. PCR ribotyping, whole-genome sequencing, and phenotypic assays were used to characterize these isolates. Genotypic and phenotypic screening of C. difficile isolates revealed multiple PCR ribotypes present and the emergence of rifamycin resistance during the infection cycle. Understanding both the clinical and bacterial factors that contribute to the course of recurrent infection could inform strategies to reduce recurrence.
Abstract.
Stevenson E, Minton NP, Kuehne SA (2015). The role of flagella in Clostridium difficile pathogenicity. Trends in Microbiology, 23(5), 275-282.
Lister M, Stevenson E, Heeg D, Minton NP, Kuehne SA (2014). Comparison of culture based methods for the isolation of Clostridium difficile from stool samples in a research setting. Anaerobe, 28, 226-229.
Butt E, Foster JAH, Keedwell E, Bell JEA, Titball RW, Bhangu A, Michell SL, Sheridan R (2013). Derivation and validation of a simple, accurate and robust prediction rule for risk of mortality in patients with Clostridium difficile infection.
BMC Infect Dis,
13Abstract:
Derivation and validation of a simple, accurate and robust prediction rule for risk of mortality in patients with Clostridium difficile infection.
BACKGROUND: Clostridium difficile infection poses a significant healthcare burden. However, the derivation of a simple, evidence based prediction rule to assist patient management has not yet been described. METHOD: Univariate, multivariate and decision tree procedures were used to deduce a prediction rule from over 186 variables; retrospectively collated from clinical data for 213 patients. The resulting prediction rule was validated on independent data from a cohort of 158 patients described by Bhangu et al. (Colorectal Disease, 12(3):241-246, 2010). RESULTS: Serum albumin levels (g/L) (P = 0.001), respiratory rate (resps /min) (P = 0.002), C-reactive protein (mg/L) (P = 0.034) and white cell count (mcL) (P = 0.049) were predictors of all-cause mortality. Threshold levels of serum albumin ≤ 24.5 g/L, C- reactive protein >228 mg/L, respiratory rate >17 resps/min and white cell count >12 × 10(3) mcL were associated with an increased risk of all-cause mortality. A simple four variable prediction rule was devised based on these threshold levels and when tested on the initial data, yield an area under the curve score of 0.754 (P
Abstract.
Author URL.
Full text.
He M, Miyajima F, Roberts P, Ellison L, Pickard DJ, Martin MJ, Connor TR, Harris SR, Fairley D, Bamford KB, et al (2013). Emergence and global spread of epidemic healthcare-associated Clostridium difficile.
Nature Genetics,
45(1), 109-113.
Abstract:
Emergence and global spread of epidemic healthcare-associated Clostridium difficile
Epidemic C. difficile (027/BI/NAP1) has rapidly emerged in the past decade as the leading cause of antibiotic-associated diarrhea worldwide. However, the key events in evolutionary history leading to its emergence and the subsequent patterns of global spread remain unknown. Here, we define the global population structure of C. difficile 027/BI/NAP1 using whole-genome sequencing and phylogenetic analysis. We show that two distinct epidemic lineages, FQR1 and FQR2, not one as previously thought, emerged in North America within a relatively short period after acquiring the same fluoroquinolone resistance-conferring mutation and a highly related conjugative transposon. The two epidemic lineages showed distinct patterns of global spread, and the FQR2 lineage spread more widely, leading to healthcare-associated outbreaks in the UK, continental Europe and Australia. Our analysis identifies key genetic changes linked to the rapid transcontinental dissemination of epidemic C. difficile 027/BI/NAP1 and highlights the routes by which it spreads through the global healthcare system. © 2013 Nature America, Inc. All rights reserved.
Abstract.
Publications by year
2017
Francis VI, Stevenson EC, Porter SL (2017). Two-component systems required for virulence in Pseudomonas aeruginosa.
FEMS Microbiology Letters,
364 Full text.
2016
Stevenson EC, Major GA, Spiller RC, Kuehne SA, Minton NP (2016). Coinfection and emergence of rifamycin resistance during a recurrent clostridium difficile infection.
Journal of Clinical Microbiology,
54(11), 2689-2694.
Abstract:
Coinfection and emergence of rifamycin resistance during a recurrent clostridium difficile infection
Copyright © 2016, American Society for Microbiology. All Rights Reserved. Clostridium difficile (Peptoclostridium difficile) is a common health care-associated infection with a disproportionately high incidence in elderly patients. Disease symptoms range from mild diarrhea to life-threatening pseudomembranous colitis. Around 20% of patients may suffer recurrent disease, which often requires rehospitalization of patients. C. difficile was isolated from stool samples from a patient with two recurrent C. difficile infections. PCR ribotyping, whole-genome sequencing, and phenotypic assays were used to characterize these isolates. Genotypic and phenotypic screening of C. difficile isolates revealed multiple PCR ribotypes present and the emergence of rifamycin resistance during the infection cycle. Understanding both the clinical and bacterial factors that contribute to the course of recurrent infection could inform strategies to reduce recurrence.
Abstract.
2015
Stevenson E, Minton NP, Kuehne SA (2015). The role of flagella in Clostridium difficile pathogenicity. Trends in Microbiology, 23(5), 275-282.
2014
Lister M, Stevenson E, Heeg D, Minton NP, Kuehne SA (2014). Comparison of culture based methods for the isolation of Clostridium difficile from stool samples in a research setting. Anaerobe, 28, 226-229.
2013
Butt E, Foster JAH, Keedwell E, Bell JEA, Titball RW, Bhangu A, Michell SL, Sheridan R (2013). Derivation and validation of a simple, accurate and robust prediction rule for risk of mortality in patients with Clostridium difficile infection.
BMC Infect Dis,
13Abstract:
Derivation and validation of a simple, accurate and robust prediction rule for risk of mortality in patients with Clostridium difficile infection.
BACKGROUND: Clostridium difficile infection poses a significant healthcare burden. However, the derivation of a simple, evidence based prediction rule to assist patient management has not yet been described. METHOD: Univariate, multivariate and decision tree procedures were used to deduce a prediction rule from over 186 variables; retrospectively collated from clinical data for 213 patients. The resulting prediction rule was validated on independent data from a cohort of 158 patients described by Bhangu et al. (Colorectal Disease, 12(3):241-246, 2010). RESULTS: Serum albumin levels (g/L) (P = 0.001), respiratory rate (resps /min) (P = 0.002), C-reactive protein (mg/L) (P = 0.034) and white cell count (mcL) (P = 0.049) were predictors of all-cause mortality. Threshold levels of serum albumin ≤ 24.5 g/L, C- reactive protein >228 mg/L, respiratory rate >17 resps/min and white cell count >12 × 10(3) mcL were associated with an increased risk of all-cause mortality. A simple four variable prediction rule was devised based on these threshold levels and when tested on the initial data, yield an area under the curve score of 0.754 (P
Abstract.
Author URL.
Full text.
He M, Miyajima F, Roberts P, Ellison L, Pickard DJ, Martin MJ, Connor TR, Harris SR, Fairley D, Bamford KB, et al (2013). Emergence and global spread of epidemic healthcare-associated Clostridium difficile.
Nature Genetics,
45(1), 109-113.
Abstract:
Emergence and global spread of epidemic healthcare-associated Clostridium difficile
Epidemic C. difficile (027/BI/NAP1) has rapidly emerged in the past decade as the leading cause of antibiotic-associated diarrhea worldwide. However, the key events in evolutionary history leading to its emergence and the subsequent patterns of global spread remain unknown. Here, we define the global population structure of C. difficile 027/BI/NAP1 using whole-genome sequencing and phylogenetic analysis. We show that two distinct epidemic lineages, FQR1 and FQR2, not one as previously thought, emerged in North America within a relatively short period after acquiring the same fluoroquinolone resistance-conferring mutation and a highly related conjugative transposon. The two epidemic lineages showed distinct patterns of global spread, and the FQR2 lineage spread more widely, leading to healthcare-associated outbreaks in the UK, continental Europe and Australia. Our analysis identifies key genetic changes linked to the rapid transcontinental dissemination of epidemic C. difficile 027/BI/NAP1 and highlights the routes by which it spreads through the global healthcare system. © 2013 Nature America, Inc. All rights reserved.
Abstract.