Whole-genome characteristics of isolates from recurrent <i>Clostridioides difficile</i> infections

<i>Clostridioides difficile</i> infection (CDI) poses a major challenge in healthcare settings due to its high recurrence rate. Accurate differentiation between relapse of the original strain and reinfection with a new strain is crucial for effective management of recurrent <i>Clostridioides difficile</i> infection (rCDI). This study combined whole-genome sequencing (WGS) and antimicrobial susceptibility testing to thoroughly examine the genomic characteristics of isolates from rCDI patients at our hospital, aiming to identify potential genomic features and key factors contributing to rCDI. Core genome analysis revealed highly consistent evolutionary trajectories between recurrent and reinfection strains, with no significant differences in their genetic lineages. This finding suggests that recurrence tendencies may be influenced more by host-specific factors or regulatory adaptations. These insights offer a new direction for developing targeted management strategies for rCDI.