INTRODUCTION: Clostridium difficile is an increasing cause of nosocomial diarrhoea and colitis. The aim of this study was to identify the prevalence and characteristics of asymptomatic C. difficile carriage in a continuing care institution for the elderly. METHODS: Stool samples were collected from 100 asymptomatic patients, whose median age was 83 years. Samples were tested for C. difficile using traditional culturing methods, 16s rDNA and 16s-23s intergenic spacer (IGS) rDNA sequencing, and analysed for toxin production and toxin genes. RESULTS: The prevalence of C. difficile carriage was 10/100 (10%) following culture and 16s and IGS sequencing. An additional seven isolates, initially identified as C. difficile, were subsequently identified by IGS rDNA sequencing as C. sordellii of the 10% that tested positive for C. difficile, seven tested positive for toxin A and B. A significant number of C. difficile carriers had recent antibiotic exposure compared with non-carriers, P = 0.046. CONCLUSION: The prevalence of asymptomatic C. difficile carriage in this institution was 10%, 7% of which were toxin positive. This study underscores the importance of increased vigilance for C. difficile using microbial and molecular methodology and identifies patients at increased risk following antibiotic administration.
INTRODUCTION:Clostridium difficile is an increasing cause of nosocomial diarrhoea and colitis. The aim of this study was to identify the prevalence and characteristics of asymptomatic C. difficile carriage in a continuing care institution for the elderly. METHODS: Stool samples were collected from 100 asymptomatic patients, whose median age was 83 years. Samples were tested for C. difficile using traditional culturing methods, 16s rDNA and 16s-23s intergenic spacer (IGS) rDNA sequencing, and analysed for toxin production and toxin genes. RESULTS: The prevalence of C. difficile carriage was 10/100 (10%) following culture and 16s and IGS sequencing. An additional seven isolates, initially identified as C. difficile, were subsequently identified by IGS rDNA sequencing as C. sordellii of the 10% that tested positive for C. difficile, seven tested positive for toxin A and B. A significant number of C. difficile carriers had recent antibiotic exposure compared with non-carriers, P = 0.046. CONCLUSION: The prevalence of asymptomatic C. difficile carriage in this institution was 10%, 7% of which were toxin positive. This study underscores the importance of increased vigilance for C. difficile using microbial and molecular methodology and identifies patients at increased risk following antibiotic administration.
Authors: Renate J van den Berg; Lesla S Bruijnesteijn van Coppenraet; Hendrik-Jan Gerritsen; Hubert P Endtz; Eric R van der Vorm; Ed J Kuijper Journal: J Clin Microbiol Date: 2005-10 Impact factor: 5.948
Authors: Marc Fischer; Julu Bhatnagar; Jeannette Guarner; Sarah Reagan; Jill K Hacker; Sharon H Van Meter; Vadims Poukens; David B Whiteman; Anthony Iton; Michele Cheung; David E Dassey; Wun-Ju Shieh; Sherif R Zaki Journal: N Engl J Med Date: 2005-12-01 Impact factor: 91.245
Authors: Sophia V Kazakova; Kim Ware; Brittany Baughman; Oleg Bilukha; Anne Paradis; Stephen Sears; Angie Thompson; Bette Jensen; Lois Wiggs; Jemelie Bessette; James Martin; Judy Clukey; Kathleen Gensheimer; George Killgore; L Clifford McDonald Journal: Arch Intern Med Date: 2006 Dec 11-25
Authors: Michelle M Riggs; Ajay K Sethi; Trina F Zabarsky; Elizabeth C Eckstein; Robin L P Jump; Curtis J Donskey Journal: Clin Infect Dis Date: 2007-09-04 Impact factor: 9.079
Authors: K J Walker; S S Gilliland; K Vance-Bryan; J A Moody; A J Larsson; J C Rotschafer; D R Guay Journal: J Am Geriatr Soc Date: 1993-09 Impact factor: 5.562
Authors: C R Clabots; S Johnson; K M Bettin; P A Mathie; M E Mulligan; D R Schaberg; L R Peterson; D N Gerding Journal: J Clin Microbiol Date: 1993-07 Impact factor: 5.948
Authors: Mary C Rea; Orla O'Sullivan; Fergus Shanahan; Paul W O'Toole; Catherine Stanton; R Paul Ross; Colin Hill Journal: J Clin Microbiol Date: 2011-12-07 Impact factor: 5.948
Authors: Seth T Walk; Ruchika Jain; Itishree Trivedi; Sylvia Grossman; Duane W Newton; Tennille Thelen; Yibai Hao; J Glenn Songer; Glen P Carter; Dena Lyras; Vincent B Young; David M Aronoff Journal: Anaerobe Date: 2011-06-25 Impact factor: 3.331
Authors: D Neofytos; K Kobayashi; C D Alonso; J Cady-Reh; D Lepley; M Harris; N Desai; E Kraus; A Subramanian; S Treadway; D Ostrander; C Thompson; K Marr Journal: Transpl Infect Dis Date: 2012-11-23 Impact factor: 2.228
Authors: E de Jong; A S de Jong; C J M Bartels; C van der Rijt-van den Biggelaar; W J G Melchers; P D J Sturm Journal: Eur J Clin Microbiol Infect Dis Date: 2012-02-14 Impact factor: 3.267
Authors: Fabio Miyajima; Paul Roberts; Andrew Swale; Valerie Price; Maureen Jones; Michael Horan; Nicholas Beeching; Jonathan Brazier; Christopher Parry; Neil Pendleton; Munir Pirmohamed Journal: PLoS One Date: 2011-08-23 Impact factor: 3.240
Authors: Edward C Couchman; Hilary P Browne; Matt Dunn; Trevor D Lawley; J Glenn Songer; Val Hall; Liljana Petrovska; Callum Vidor; Milena Awad; Dena Lyras; Neil F Fairweather Journal: BMC Genomics Date: 2015-05-16 Impact factor: 3.969