Figure 3.

BWH patient isolates are genomically diverse. A, Clostridioides difficile SNP cluster tree of 157 SNP clusters, represented by 1 isolate, and 256 nonclustered isolates are shown. The outer ring shows the source of strains present in the branch (stool or VRE swab) and number of isolates. A bar graph in the second ring indicates the number of strains the branch represents in the NCBI Pathogen Detection Isolates Browser. The inner rings indicate presence (purple) or absence (black) of different toxin genes found within each clade. Clades are indicated by a colored box around the interior nodes that compose the clade. B, Inset of panel A showing an interactive view available online with the sequence types and strains represented in each leaf. C and D, Percentage of different toxin types from stool (C) or VRE swabs (D). The difference in non–toxin-encoding strains found in swabs versus stool samples is significant at P < .001. Abbreviations: BWH, Brigham and Women's Hospital; CDI, Clostridioides difficile infection; NCBI, National Center for Biotechnology Information; SNP, single nucleotide polymorphism; VRE, vancomycin-resistant enterococci.