Regulation of Type IV Pili Contributes to Surface Behaviors of Historical and Epidemic Strains of Clostridium difficile
ABSTRACTThe intestinal pathogenClostridium difficileis an urgent public health threat that causes antibiotic-associated diarrhea and is a leading cause of fatal nosocomial infections in the United States.C. difficilerates of recurrence and mortality have increased in recent years due to the emergence of so-called “hypervirulent” epidemic strains. A great deal of the basic biology ofC. difficilehas not been characterized. Recent findings that flagellar motility, toxin synthesis, and type IV pilus (TFP) formation are regulated by cyclic diguanylate (c-di-GMP) reveal the importance of this second messenger forC. difficilegene regulation. However, the function(s) of TFP inC. difficileremains largely unknown. Here, we examine TFP-dependent phenotypes and the role of c-di-GMP in controlling TFP production in the historical 630 and epidemic R20291 strains ofC. difficile. We demonstrate that TFP contribute toC. difficilebiofilm formation in both strains, but with a more prominent role in R20291. Moreover, we report that R20291 is capable of TFP-dependent surface motility, which has not previously been described inC. difficile. The expression and regulation of thepilA1pilin gene differs between R20291 and 630, which may underlie the observed differences in TFP-mediated phenotypes. The differences inpilA1expression are attributable to greater promoter-driven transcription in R20291. In addition, R20291, but not 630, upregulates c-di-GMP levels during surface-associated growth, suggesting that the bacterium senses its substratum. The differential regulation of surface behaviors in historical and epidemicC. difficilestrains may contribute to the different infection outcomes presented by these strains.IMPORTANCEHowClostridium difficileestablishes and maintains colonization of the host bowel is poorly understood. Surface behaviors ofC. difficileare likely relevant during infection, representing possible interactions between the bacterium and the intestinal environment. Pili mediate bacterial interactions with various surfaces and contribute to the virulence of many pathogens. We report that type IV pili (TFP) contribute to biofilm formation byC. difficile. TFP are also required for surface motility, which has not previously been demonstrated forC. difficile. Furthermore, an epidemic-associatedC. difficilestrain showed higher pilin gene expression and greater dependence on TFP for biofilm production and surface motility. Differences in TFP regulation and their effects on surface behaviors may contribute to increased virulence in recent epidemic strains.