Prevalence Of Clostridium Difficile Research Articles

The Prevalence of Clostridium difficile and Clostridium perfringens in Minced and Ground Beef in Iran

The Prevalence of Clostridium difficile and Clostridium perfringens in Minced and Ground Beef in Iran

Selectivity in the Formation of Straight-Chain Versus Cyclised products on Knoevenagel Condensation between Thiobarbituric acid and Naphthaldehydes

The prevalence of Clostridium difficile (CD) infection has grown rapidly due to resistance and the emergence of new, highly virulent strains of the organism that have become less sensitive to many antibiotics. Vancomycin and metronidazole are front-line treatments of CD infection that still show good efficacy, but their effectiveness has declined for the treatment of recurrent infection and less sensitive strains of CD. More recently, the macrolide antibiotic fidaxomicin been introduced in the treatment of CD infection. Its high cost and limited usefulness against recurrent infection has prompted the search for new, narrow spectrum agents. We identified the CD dihydroorotate dehydrogenase (DHODase) as a potential enzyme target for the design of Knoevenagel products formed from reaction of 2-thiobarbituric acid and naphthaldehyde substrates. The presence of a hydroxyl substituent at position C2 in the naphthaldehyde ring offers the possibility to form the Knoevenagel product and to cyclize to give the tetracyclic, oxadeazaflavine with benzo-homologation. In this work, the selectivity for straight-chain formation over competing cyclisation on Knoevenagel condensation between thiobarbituric acid and naphthaldehyde substrates was examined. The outcomes of uncatalyzed condensations in refluxing ethanol were investigated by various methods including high field 1H and 13C NMR. Unsubstituted naphthaldehyde and its 2-methoxyl derivative favored straight-chain product formation whereas use of 2-hydroxynaphthaldehyde favored cyclisation and concomitant Michael addition of a second molecule of the corresponding acid to the newly formed exocyclic C=C bond. The pattern of reactivity was mirrored in the benzaldehyde series where the presence of the 2-hydroxyl function led to cyclized products with concomitant formation of the Michael adducts. The Knoevenagel products and the benzo-homologated oxadeazaflavine derivatives are candidates for evaluation as potential growth inhibitors of CD.

Prevalence of Clostridium difficile in Hospital Environment within Yola Adamawa State Nigeria

Introduction: Clostridium difficile infection (CDI) is an emerging health problem in hospital setting. The ability of the spores to persist in the environment is a key factor in rates of infection. Clostridium difficile has also been described as one of the leading cause of nosocomial diarrhea. It is responsible for an increase in hospital stay with high healthcare and economic repercussions. Objectives: This study was aimed at determining the prevalence and antimicrobial susceptibility profile of Clostridium difficile isolated from surfaces within hospital environment in Yola Adamawa State Nigeria. Materials and Methods: A total of 150 surface samples were collected from different wards of two hospitals (Specialist Hospital Yola (SHY) and Federal Medical Centre Yola (FMCY)) using moistened swabs. Clostridium difficile isolates were obtained by enriching and culturing samples in cycloserine-cefoxitin fructose broth (CCFB) and cycloserine-cefoxitin fructose agar (CCFA) respectively. Susceptibility test (MIC determination) was done by well diffusion technique on Mueller Hinton agar supplemented with 5% sodium taurocholate. Results: A total of 18 (12%) Clostridium difficile were recovered from the two hospitals sampled. FMC had a prevalence rate of 13.3% with table top, toilet, window and bed sheets as sites implicated while SHY had a prevalence rate of 10.7% with bed sheet, bed railing and window as implicated sites. The antibiotic susceptibility test reveals that Clostridium difficile isolates obtained were resistant to the antibiotics tested which includes Ciprofloxacin (MIC >64 µg/ml), Erythromycin (MIC >64 µg/ml), Metronidazole (MIC 64 µg/ml), Tetracycline (MIC > 128 µg/ml) and Clindamycin (MIC > 64 µg/ml). Conclusions: The study depicts that multidrug resistant Clostridium difficile is prevalent in hospital environments within Yola Adamawa State Nigeria. The need for the sensitization of healthcare workers to improve understanding of Clostridium difficile transmission, treatment, management and prevention is of paramount importance.

Evaluation of inpatients Clostridium difficile prevalence and risk factors in Cameroon

BackgroundClostridium difficile, rarely found in hospitals, is a bacterium responsible for post-antibiotic diarrhea and Pseudomembranous Colitis (CPM). C. difficile selective pressure represents potential public health problem due to the production of toxins A and B serious pathologies effects/consequences. A transversal and analytic study was to assess the risk factors of C. difficile infection and to determine the prevalence of C. difficile in patients received in randomly selected five hospitals in Yaoundé, Cameroon.MethodsA total of 300 stool samples were collected from consented patients using a transversal and analytic study conducted from 10th July to 10th November 2018 in five hospitals in Cameroon. The detection or diagnostic kit was CerTest C. difficile Glutamate Dehydrogenase + Toxin A + Toxin B based on immuno-chromatographic assay. A univariate and multivariate analysis allowed us to highlight the associated factors.ResultsThe results showed a prevalence of C. difficile of 27.33% (82/300 stool patients’samples taken). Of these 27.33%, the production of Toxin A and Toxin B were 37.80 and 7.31% respectively. In univariate analysis, hospitalization was a significant (P = 0.01) risk factor favoring C. difficile infection. In multivariate analysis, corticosteroids and quinolones use/administration were significantly (adjusted Odd Ratio, aOR = 14.09, 95% CI: 1.62–122.54, P = 0.02 and aOR = 3.39, 95% CI: 1.00–11.34, P = 0.05 respectively) risk factor for this infection.ConclusionThe prevalence of C. difficile infections (CDI) remain high in these settings and may be related not only to permanent steroids and antibiotics. Promoting education to both medical staff and patients on the prevalence and public health impact of C. difficile can be core inimproving rationale prescription of steroids and antibiotics to patients and promote human health and exponential growth in Cameroon.

Prevalence of Clostridium difficile and Clostridium perfringens in Swiss horses with and without gastrointestinal disease and microbiota composition in relation to Clostridium difficile shedding

Overgrowth of enteric clostridia in dysbiosis in horses with colic is presumed but scarcely investigated. The objective was to provide prevalence data of Clostridium difficile and Clostridium perfringens in horses with and without gastrointestinal disease in Switzerland, and investigate microbiota differences between C. difficile shedders and non-shedders.Fecal samples were taken from healthy horses (n = 103), horses with colic (n = 98) and horses with diarrhea (n = 151). Colic horses were sampled on three days. Selective enrichment culture and molecular typing for C. difficile and C. perfringens was performed. Microbiota differences between horses with colic shedding (n = 7) and not shedding (n = 7) C. difficile were assessed using metagenomic sequencing.The cumulative prevalence (19% C. difficile; 16% C. perfringens) was higher compared to single day samples (1–10% C. difficile; 3–8% C. perfringens, all p < 0.003). Horses with colic shed significantly more C. difficile (p < 0.001) but not C. perfringens (p = 0.09) compared to healthy horses. Prevalence in horses with diarrhea was 8% for both Clostridium species. There were no significant microbiota differences between C. difficile shedders and non-shedders with regards to relative abundance on any phylogenetic level, and alpha diversity. Limited differences were seen on LEfSE analysis and in beta diversity indices.Multiple fecal samples should be taken when investigating shedding of enteric clostridia. As horses with colic shed more enteric clostridia compared to healthy horses special biosecurity protocols for horses with colic should be considered in hospitals. Differences in microbiota composition between C. difficile shedders and non-shedders were limited. Further studies on the role of dysbiosis in C. difficile are needed.

Clinico-Microbiological Analysis of Toxigenic Clostridium difficile from Hospitalised Patients in a Tertiary Care Hospital, Mangalore, Karnataka, India

AbstractPurpose: Prevalence of Clostridium difficile, an anaerobic, Gram-positive, spore-forming bacillus, is very much underestimated in India. The present study was intended to assess the burden of toxigenic C. difficile in hospitalised patients with clinically significant diarrhoea and analysis of their clinical picture. Materials and Methods: This cross-sectional study was conducted in a tertiary care teaching hospital, South India, from January 2012 to December 2014. Stool samples were collected consecutively from 563 inpatients from various wards. The prevalence of toxigenic C. difficile was determined by toxigenic culture and a two-step algorithm. The clinical spectrum of these patients was also analysed. Associated pathogens were identified using standard procedures. Statistical analysis was done by frequency, percentage, Chi-square test and z-test. Results: Out of the 563 stool samples analysed, the prevalence of toxigenic C. difficile was 12.79% and that of non-toxigenic C. difficile was 10.83%. The prevalence of toxigenic C. difficile among oncology patients was highly significant (HS). Antibiotic treatment, prolonged hospital stay and underlying diseases/conditions were the risk factors which were HS, and fever was the significant clinical feature among the patients. Escherichia coli was the predominant associated pathogen isolated (18.47%). Conclusion: The presence of toxigenic C. difficile in our locality is a matter of concern. Constant supervision, appropriate treatment and preventive measures are crucial in controlling C. difficile infection.

High prevalence of Clostridium difficile in the Western Australian environment

High prevalence of Clostridium difficile in the Western Australian environment

DETEKSI CLOSTRIDIUM DIFFICILE TOKSIGENIK MENGGUNAKAN UJI CEPAT TOKSIN DAN REAL TIME POLYMERASE CHAIN REACTION (Toxigenic Clostridium Difficile Detection Using Toxin Rapid Test and Real Time Polymerase Chain Reaction)

Toxigenic Clostridium difficile infection, causing a Pseudo Membrane Colitis (PMC) and Clostridium Difficile Associated Diarrhea(CDAD) has increased sharply. The largest risk factor is the use of antibiotics. The purpose of this study was to know how to determinethe prevalence and characteristics of subjects with Toxigenic Clostridium difficile and to assess the ability of the toxin rapid test comparedto real-time PCR. Ninety adult subjects with antibiotic therapy more than two (2) weeks were enrolled in this study. The results of toxinrapid test and real-time PCR were presented in a 2x2 table, statistical test used was Chi square. The prevalence of Toxigenic Clostridiumdifficile based on the toxin rapid test and by real-time PCR was 27.3% and 37.5%, respectively. There were significant differences betweenstool consistency and number of antibiotics used with the detection of Toxigenic Clostridium difficile. There was a relationship betweenthe duration of antibiotic therapy with the detection of Toxigenic Clostridium difficile using real-time PCR (p=0.010, RR=2.116). Thesensitivity, specificity, PPV, NPV, PLR and NLR rapid test against real-time PCR were 69.7%; 98.2%; 95.8%; 84.4%; 39.2 and 0.31,respectively. This study concluded that the prevalence of Clostridium difficile in RSCM was higher compared to that in Malaysia, Thailandand India; the subjects with antibiotic therapy for more than four (4) weeks had a double risk to have Toxigenic Clostridium difficilethan subjects with antibiotic therapy for less than that time (4 weeks). Thus, in this study, toxin rapid test could be used as a tool todetect Toxigenic Clostridium difficile.

The prevalence of Clostridium difficile in cattle and sheep carcasses and the antibiotic susceptibility of isolates

Clostridium difficile is an anaerobic, spore forming, rod shaped bacterium frequently isolated from butchery animals in recent years. The aim of this study is to evaluate the presence of C. difficile (especially ribotype 027 and 078) in cattle and sheep carcasses and to investigate the antibiotic susceptibility of isolates. The bacterium was isolated in 83 out of 247 (33.6%) cattle and 78 out of 308 (25.3%) sheep carcass samples. 15/83 (18.1%) cattle and 6/78 (7.7%) sheep isolates were identified as ribotype 027, whereas the other hypervirulent isolate ribotype 078 could not be detected among the analysed samples. Almost all isolates were susceptible to amoxicillin-clavulanic acid (98.8%), vancomycin (96.9%) and tetracycline (97.5%), whereas resistant to cefotaxim (97.5%) and imipenem (87.0%). In conclusion, the results demonstrate the presence of toxigenic C. difficile isolates in cattle and sheep carcasses on the slaughter line. As a result, the results of this study demonstrate the presence of toxigenic C. difficile isolates in cattle and sheep carcasses on the slaughter line.

Prevalence of Clostridium difficile and Multidrug Resistant Gram-negative Rods in the Soil from Southeastern Wisconsin

BackgroundPreliminary data suggests that community-onset Clostridium difficile might be more common in rural areas. Thus, farms—specifically livestock farms—might be a major reservoir of C. difficile. Similarly, antibiotic exposures might predispose farm animals for colonization with multidrug resistant Gram-negative organisms. The aim of this study was to determine the prevalence of C. difficile and multidrug resistant gram-negative rods in the soil of Southeastern Wisconsin farms.MethodsFrom July to September of 2016, soil samples were collected from farms with livestock animals. Soil samples were collected using gloves and sample containers. Soil samples were collected from farms specifically in or near Washington, Waukesha, and Milwaukee counties which are within the proximity of Milwaukee Metro area. Soil samples were cultured for C. difficile and Gram-negative rods on selective plates and by broth enrichment.ResultsA total of 20 farms participated in this study with a total of 40 soil samples. Out of the 40 soil samples, 20 were from an area where animals roam or where manure was used and the remaining 20 were from an area where animals are prohibited or where there was no manure. Out of the 20 soil samples where animals roam, 10 (50%), tested positive for C. difficile. Out of 20 soil samples where animals are prohibited, 13 samples (65%) tested positive for C. difficile. 2 of the 23 C. difficile isolates recovered were toxigenic. Eight (40%) of the 20 soil samples where animals roam tested positive for fluoroquinolone-resistant bacteria (FQR). While 5 (25%) of the 20 soil samples where animals are prohibited, tested positive for FQR bacteria. An Acinetobacter calcoaceticus was found to exhibit carbapenem-resistance.ConclusionWe found soil colonization with C. difficile and FQR in 65% and 25%, respectively, where animals are prohibited. Where animals roam we found C. difficile and FQR 50% and 40%, respectively. Our study suggests that farms may be a significant community source for C. difficile and fluoroquinolone resistant organisms. Additional testing should be done to examine factors that might be increasing antibiotic resistance in farms (e.g., antibiotic exposure).Disclosures All authors: No reported disclosures.

Prevalence and risk factors for colonization of Clostridium difficile among adults living near livestock farms in the Netherlands.

A cross-sectional study was performed among 2494 adults not living or working on a farm to assess prevalence of Clostridium difficile (CD) colonization and risk factors in a livestock dense area. CD prevalence was 1·2%. Twenty-one persons were colonized with a toxigenic strain and nine with a non-toxigenic strain. CD-positive persons did not live closer to livestock farms than individuals negative for CD. Antibiotic exposure in the preceding 3 months was a risk factor for CD colonization (odds ratio 3·70; 95% confidence interval 1·25-10·95).

Prevalence and risk factors for colonization by Clostridium difficile and extended-spectrum β-lactamase-producing Enterobacteriaceae in rehabilitation clinics in Germany

Rehabilitation clinics may vary widely in terms of type of care provided, duration of hospital stay, and case severity. Few data are available on prevalence of Clostridium difficile or extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) colonization in rehabilitation clinics in Germany. This study investigated the frequency of intestinal colonization by these pathogens among patients in rehabilitation clinics of different specialization. In the scope of a point prevalence study, faecal samples and demographic and clinical data were collected in five rehabilitation clinics. Samples were screened for C.difficile and ESBL-E by culture. Isolates were characterized by polymerase chain reaction for C.difficile toxins A and B, for β-lactamase genes, and by molecular typing including pulsed-field gel electrophoresis and PCR-based ribotyping. Of 305 patients screened, 11.1% were colonized by toxigenic C.difficile and 7.5% by ESBL-E. Colonization rates differed markedly between facilities, ranging from 1.6% to 26.3% for C.difficile and from zero to 23.7% for ESBL-E. Prevalence of colonization by C.difficile and ESBL-E was higher in neurological rehabilitation clinics than in clinics with other specialties (P<0.001). Molecular typing revealed six patients from one neurological rehabilitation clinic harbouring a unique C.difficile strain (ribotype 017). CTX-M-15 was the most prevalent ESBL type. We detected several indistinguishable pairs of ESBL-E isolates within some facilities. Significant differences were found in the prevalence of C.difficile and ESBL-E between rehabilitation clinics. Facilities providing specialized medical care for critically ill patients had higher prevalence rates. These results may help to delineate the requirements for infection prevention and control in rehabilitation clinics.

Detection of Clostridium difficile and toxin genes in samples of modified atmosphere packaged (MAP) minced and cubed beef meat

In this study it is intended to find out the prevalence of Clostridium difficile in modified atmosphere packaged (MAP) minced (n:50) and cubed beef meat samples (n :50); determine the toxin from the isolates and detect the antibiotic susceptibility against metronidazole, vancomycin and clindamycin. C. difficile isolates have been isolated from two (4%) of 50 minced beef meat samples; one (2%) of 50 cubed beef meat samples. All three isolates were confirmed by PCR as C. difficile by the detection of tpi gene. Three out of 5 C. difficile isolates showed toxigenic character, two of them were carried type B (tcdB) toxin genes, one of them harbored type A (tcdA) toxin gene. When antibiotic resistance profile was phenotypically analyzed, only C. difficile type A (tcdA) was found resistant against clindamycin. All isolates were found sensitive to vancomycin and metronidazole. The result of this study demonstrated that C. difficile strains detected in samples of modified atmosphere packaged (MAP) beef meat could be a potential problem to public health

Isolation of Clostridium difficile from dogs with digestive disorders, including stable metronidazole-resistant strains

The prevalence of Clostridium difficile in 107 dogs with diverse digestive disorders attended in a Spanish veterinary teaching hospital was assessed. The microorganism was isolated from 13 dogs (12.1%) of different disease groups. Isolates belonged to PCR ribotypes 078, 106, 154 and 430 (all of them toxigenic) and 110 (non-toxigenic), and were resistant to several antimicrobial drugs. Notably, seven isolates obtained from different dogs displayed stable resistance to metronidazole. The results of this study provide further evidence that dogs can act as a reservoir of C. difficile strains of epidemic ribotypes with resistance to multiple antibiotics.

Survival and prevalence of Clostridium difficile in manure compost derived from pigs

Pigs, particularly piglets, have been identified as reservoir hosts of Clostridium difficile. To examine the survival ability of this pathogen in pig feces-based manure compost, C. difficile spores, which were prepared to contain as few vegetative cells as possible, were artificially inoculated into pig feces and incubated at different temperatures. While C. difficile survived in the feces incubated at temperatures below 37 °C for over 30 days, cell numbers gradually decreased at thermophilic temperatures (over 55 °C; p < 0.05). Next, to clarify the prevalence of C. difficile in field manure compost, we isolated and characterized C. difficile from the final products of manure compost products of 14 pig farms. A total of 11 C. difficile strains were isolated from 5 of 14 (36% positive rate) samples tested. Of these 11 strains, 82% were toxigenic, with ribotype 078 being the most prevalent. Thus, the application of composted manure to land therefore poses a possible risk of C. difficile transfer to the food chain.

Disparate prevalence of toxigenic and nontoxigenic Clostridium difficile among distinct adult patient populations in a single institution.

Clostridium difficile (CD) disease remains a costly and important hospital-associated infection. Although nontoxigenic CD is detected by some CD testing methods, can interfere with some detection algorithms and has been suggested as a treatment for CD disease, little is known about the relative occurrence of toxigenic and nontoxigenic CD in a single institution.We used both chromogenic and selective agar media to recover CD isolates and a molecular method to detect the toxin B gene from over 2400 fresh unformed stool specimens with isolates further tested for the toxin B gene. We recovered 74 nontoxigenic and 306 toxigenic CD isolates for which a collection site could be assigned.The frequency of recovery of toxigenic and nontoxigenic CD for each hospital location and the ratio of toxigenic to nontoxigenic CD were calculated. Although the overall prevalence of toxigenic and nontoxigenic CD was 12.7 % and 3.1 %, respectively, on some wards, 48 % of all CD were nontoxigenic, while on other wards, ≤5 % were nontoxigenic.The disparate ratios of nontoxigenic CD to toxigenic CD presented here for the various 'groups' within the adult veteran population are important to the ongoing discussion and reexamination of other published work on the occurrence of toxigenic and nontoxigenic CD, for evaluating the performance of CD detection tests, for designing infection control strategies and in ultimately understanding both CD carriage and disease.

Prevalence of Clostridium difficile in raw cow, sheep, and goat meat in Jazan, Saudi Arabia.

Background:Clostridium difficile has been shown to be a nosocomial infection associated with diarrhoea and pseudomembranous colitis in hospitalized patients especially old patients. In my previous studies, it was shown the occurrence of C. difficile in animals feces and vegetables which may act as a source of infection to humans.The aim of the study was to determine the prevalence of C. difficile in retail raw cow, sheep, and goat, meat in Jazan, Saudi Arabia.Method: A total of 600 raw meat samples from cow, sheep, and goat were collected during June–December 2015, and tested for the presence of C. difficile. The method used to check for the presence of C. difficile was by choosing selective enrichment media in C. difficile broth, followed by alcohol shock-treatment and plating onto C. difficile selective medium. C. difficile isolates were typed using PCR ribotyping and also analyzed for antibiotic susceptibility.Results: It was shown that, 9 of 600 meat samples (1.5%) were contaminated with C. difficile. The prevalence of C. difficile was as follow: 7 out of 600 (1.17%) were found in cow, 2 out of 600 (0.3%) were found in sheep, while was no C. difficile was isolated from goat. Eleven out of 18 C. difficile isolates were positive for tcdA, tcdB and cdtB toxin genes and were classified as ribotype 078. Three strains were positive tcdA, and tcdB, and two strains possessed only tcdB. C. difficile strains showed high resistance to ampicillin, gentamycin, erythromycin and nalidixic acid.Conclusions: The present work shows the potential risk of raw meet in transmitting C. difficile to humans.

Changing trends of clostridium difficile associated diarrhoea (cdad) in a tertiary care hospital in kolkata, india

In this era of increased and indiscriminate antibiotic usage, it is not only the advent of multi-drug resistant pathogens, but also the rising prevalence of Clostridium difficile Associated Diarrhoea (CDAD) which is drawing concern world-wide. It is important not only to implement a comprehensive antibiotic policy, but also to take up stringent infection control measures to curb the rise of this serious infection.

Prevalence of clostridium difficile among paediatric patients in a tertiary care hospital, coastal karnataka, South India.

The study was intended to analyse the burden of Clostridium difficile (C. difficile) and associated intestinal pathogens from children with diarrhoea who were hospitalized in a tertiary care teaching hospital of South India. Stool samples from 138 children with diarrhoea belonging to the age group 0-14 years were analysed by semi quantitative culture, latex agglutination and enzyme immunoassay for C. difficile. The associated intestinal pathogens were also detected from the specimens by standard procedures. Stool samples of 138 children were tested during the period; 21 (15.22%) samples were culture positive for C. difficile and the isolates were confirmed by biochemical reactions. 9(6.52%) were positive by latex agglutination. EIA for C. difficile toxins A and B was done on all the stool specimens and 15 were found to be positive (10.87 %). According to the reference standard method employed in our study, 4 toxigenic C. difficile isolates (2.90%) were obtained from 138 specimens. Among the other intestinal pathogens, Escherichia coli predominated (22.46%). Rota virus was detected in 7.27% stool samples of children under the age of five years. The study shows the prevalence of C. difficile in hospitalized children in our locality which highlights the importance of judicious use of antibiotics and strict infection control measures.

Seek and you shall find: Prevalence of Clostridium difficile in Wuhan, China

Clostridium difficile infection (CDI) is one of the leading health care acquired-infections in the United States, but much of the epidemiology and burden of disease is unknown in China. The aim of this study was to determine the prevalence and possible risk factors of CDI among hospitalized patients with diarrhea in Wuhan, China. The overall prevalence of CDI was 28% (31/111). The findings of this study suggest the prevalence of CDI in hospitalized patients with diarrhea is higher then what has been previously reported in the current literature.