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. 2021 Dec 1;10(1):2244–2255. doi: 10.1080/22221751.2021.2005453

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© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Figure 4. — Transmission links. A. C. difficile transmission pattern in the hospital. The date on the top represents the time the strain was isolated, and each strain is placed in the corresponding month, with horizontal distances between strains representing the time difference in isolation. Strains in the same yellow line belong to the same CG and ST/RT. The pink human icons represent asymptomatic carriers, and the red icons represent patients with CDI. HP and HE represent strains sourced from hospitalized patients and the ICU environment, respectively. Strains HE5, HE6, and HE7 were isolated from the toilet, HE3 and HE8 were isolated from the mop, HE2 and HE12 were isolated from the floor, and HE9 was isolated from a gown. The three strains from patients with CDI to the left of the yellow dashed line were isolated from 2016 to 2017. B. Transmission pattern of C. difficile strains from different sources. The dashed lines indicate transmission links in the hospital, and the solid lines indicate transmission links between the farms and the hospital. The CGs/STs/RTs near the lines are shared by the sources at both ends of the lines. ST, sequence type; RT, ribotype; CG, clonal group.