Strains and plasmids used in this study are listed in
Table 1, whereas primers are listed in
Table 2. The genes encoding
cdtA and
cdtB were deleted from
C difficile R20291Δ
pyrE using allelic-exchange technology [16 (
link)]. To achieve this, left and right homology arms corresponding to the regions annealing immediately upstream and downstream of
cdtA/B were amplified by polymerase chain reaction (PCR) using
cdtAB LAF/RAR and
cdtAB RAF/RAR primer sets, respectively. The homology arms were then spliced together by overlap-extension (SOEing) PCR by means of their overlapping 20-base pair (bp) homologous regions before cloning the ensuing product into pMTL-YN4 using flanking
SbfI-
AscI restriction sites, thus generating the knockout cassette (KOC) pMTL-YN4-
cdtAB KOC. The plasmid was then conjugated into
C difficile R20291Δ
pyrE exactly as previously described, and transconjugants were selected on the basis of thiamphenicol resistance [17 (
link)]. Thereafter, single crossover integrants (SCOs) were identified by 2 parallel PCR screens using
cdtAB diag F/YN4 primers for left arm recombinants and YN4 F/
cdtAB diag R primers for right arm recombinants, respectively (data not shown). To select for double crossover recombinants, SCO integrants were harvested, diluted 1 × 10
−3, and cultured onto
C difficile minimal medium (CDMM) [18 (
link)] containing 500 µg/mL 5-fluoroorotic acid and 1 µg/mL uracil, to force plasmid loss through the counter-selection marker
pyrE and to select for double crossover mutants before confirming plasmid loss on the basis of thiamphenicol sensitivity. The intended deletions were confirmed by PCR analysis using
cdtAB diag F/R primers. The deletion mutant generated an approximately 4-kbp product, while its wild-type (WT) counterpart generated a 4.6-kbp product (
Figure 1A). Finally, the
pyrE allele was restored to WT using pMTL-YN2 exactly as described previously [17 (
link)].
Strains differentially producing CDTa or CDTb were generated by the integration of either
cdtA or
cdtB at the
pyrE locus, under the control of
cdtA promoter P
cdtA. First,
cdtA coupled with its native promoter was amplified by PCR using P
cdtA F and
cdtA R primers, the product of which was cloned into pMTL-YN2C by means of flanking
NotI-
BamHI restriction sites, thus generating the complementation cassette pMTL-YN2C-P
cdtA-cdtA. In a similar fashion, pMTL-YN2C-P
cdtA-cdtB was generated by amplifying P
cdtA using P
cdtA F/P
cdtA LAR primers, and
cdtB was generated using
cdtB RAF/
cdtB RAR primers, before SOEing the products together and cloning them into pMTL-YN2C by means of flanking
NotI-
SalI restriction sites. The CDTb-encoding construct could only be generated with a single-nucleotide polymorphism in the promoter region of P
cdtA using an A-G substitution at position-124 relative to the start codon. The resultant plasmids were applied in parallel, to individually integrate the respective CDT constructs at the
pyrE locus of R20291Δ
pyrEΔ
cdtAB concomitant with the repair of
pyrE, after successful conjugation and selection for uracil prototrophs on CDMM lacking uracil. The PCR analysis using primer
pyrE WT F, coupled with either
cdtA R or
cdtB RAR, demonstrated effective knock-in at the
pyrE locus (
Figure 1B), thus generating strains R20291Δ
cdtAB*P
cdtA-cdtA and R20291Δ
cdtAB*P
cdtA-cdtB.
Simpson M., Bilverstone T., Leslie J., Donlan A., Uddin M.J., Petri W.A., Marin N., Kuehne S., Minton N.P, & Petri WA J.r. (2023). Clostridioides difficile Binary Toxin Binding Component Increases Virulence in a Hamster Model. Open Forum Infectious Diseases, 10(3), ofad040.