Abstract
BackgroundClostridium difficile (CD) is the leading cause of infectious health-care associated diarrhea. However, little is known regarding CD carriage and transmission amongst asymptomatic colonizers. We evaluated carriage, characterized strains and examined epidemiologic linkages in asymptomatic colonized CD patients.MethodsRectal swabs from asymptomatic patients admitted to the general medicine ward from April 1-June 30 2012 were collected. PCR-confirmed CD colonies were ribotyped and characterized by Modified-Multi Locus Variable Number Tandem Repeat Analysis (MMLVA).Results1549-swabs were collected from 474-patients. Overall, 50/474(10.6%) were CD PCR-positive, 24/50 were colonized at admission, while 26/50 were first identified > = 72 hours after admission. Amongst the 50 CD PCR-positive patients, 90% were asymptomatically colonized and 80% of individuals carried toxigenic CD-strains, including ribotype-027 (5/45:11%). MMLVA revealed five-clusters involving 15-patients harboring toxigenic (4/5) and non-toxigenic CD strains (1/5). In two clusters, patients were CD positive on admission while in the other three clusters involving 10 patients, we observed CD transmission from asymptomatically colonized patients to 8 previously CD-negative patients.ConclusionsWe identified increasing rates of colonization during admission to medical wards. MMLVA typing effectively discriminated between strains and suggests that 20% of patients with CD colonization acquired their strain(s) from asymptomatically colonized individuals in hospital.
Highlights
Clostridium difficile (CD) is the leading causes of infectious healthcare-associated diarrhea [1]
Modified-Multi Locus Variable Number Tandem Repeat Analysis (MMLVA) typing effectively discriminated between strains and suggests that 20% of patients
The development of CD disease is closely related to perturbations of the resident GI flora, which may be due to changes in the host, the host’s environment or direct alterations to the host GI tract as a consequence of antimicrobial therapy[5,6,7]
Summary
Clostridium difficile (CD) is the leading causes of infectious healthcare-associated diarrhea [1]. Asymptomatic colonization of CD is common since the bacteria can colonize the gastrointestinal (GI) tract and make up part of the normal flora. The development of CD disease is closely related to perturbations of the resident GI flora, which may be due to changes in the host (advancing age), the host’s environment (hospitalization, admission to a long term care facility) or direct alterations to the host GI tract as a consequence of antimicrobial therapy[5,6,7]. Clostridium difficile (CD) is the leading cause of infectious health-care associated diarrhea. Little is known regarding CD carriage and transmission amongst asymptomatic colonizers. We evaluated carriage, characterized strains and examined epidemiologic linkages in asymptomatic colonized CD patients
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
