Asymptomatic carriers were detected carrying several toxigenic (filled boxes) and non-toxigenic (unfilled boxes) ribotypes, including the hyper-virulent ribotype-027 (MS002, MS024, MS033, MS077, MS196, MS351, MS460, and MS472). In some cases an individual was asymptomatically colonized with multiple toxigenic ribotypes including ribotype-027 and ribotype-078 (MS147). Other toxigenic isolates were also prevalent in our patient population including ribotypes 014, 015, 078, 081, 449. Of note, one asymptomatic participant harbored both toxigenic and non-toxigenic CD isolates together (MS017). TcdA–toxin gene A, TcdB–toxin gene B, CdtB–binary toxin gene.