Types A and F Clostridium perfringens in healthcare wastewater from Ghana

Abstract

ABSTRACT Clostridium perfringens can cause a plethora of diseases in humans and animals, making it a growing public health concern. Insight into C. perfringens genomic studies has enhanced our understanding of the diversity and evolution of this bacterium. However, most of these studies were centered on clinical strains from human and animal hosts, with limited data from environmental sources and developing countries. Here, we present genomic and phenotypic insights into C. perfringens strains from hospital wastewater samples from Ghana. Antibiotic susceptibility testing, toxinotyping, and whole-genome sequencing were performed on the seven C. perfringens isolates. The strains were susceptible to all antibiotics screened except for three strains that were resistant to clindamycin. The majority of these strains were type F strains, characterized by a chromosomally encoded cpe gene, whereas the remaining strains were classified as type A. The cpe gene is flanked upstream by IS 1469 and downstream by IS 1470 . The genotype for the type F strains was ST721, whereas the type A strains were assigned to ST722, ST143, and ST211. Our type F strains clustered with other strains all within phylogroup I, which are mostly associated with foodborne illnesses, whereas the type A strains were grouped within phylogroup III. This study provides the first genomic characterization of C. perfringens from West Africa and contributes to further understanding of genomic diversity in C. perfringens . Moreover, the possible disseminated situation of C. perfringens in the environment highlights the need to monitor this bacterium in clinical specimens in Ghana. IMPORTANCE Clostridium perfringens causes gas gangrene and food poisoning in humans, and monitoring this bacterium is important for public health. Although whole-genome sequencing is useful to comprehensively understand the virulence, resistome, and global genetic relatedness of bacteria, limited genomic data from environmental sources and developing countries hamper our understanding of the richness of the intrinsic genomic diversity of this pathogen. Here, we successfully accumulated the genetic data on C. perfringens strains isolated from hospital effluent and provided the first evidence that predicted pathogenic C. perfringens may be disseminated in the clinical environment in Ghana. Our findings suggest the importance of risk assessment in the environment as well as the clinical setting to mitigate the potential outbreak of C. perfringens food poisoning in Ghana.