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Clostridioides (Clostridium) difficile Hypervirulent Clade 2 belong to the best studied clades consisting of several strains attributed to the most severe clinical outcomes and increased rates of spread/recurrence.
The emergence of hypervirulent clade 2 Clostridioides difficile is associated with severe symptoms and accounts for >20% of global infections.
C. difficile clade 2 strains exclusively express two TcdB disease-causing toxin variants (TcdB2 and TcdB4) that use unknown receptors distinct from the classic TcdB.
Tissue factor pathway inhibitor (TFPI) is identified as the TcdB4 receptor.