Ling Yuan Kong1, Nandini Dendukuri1, Ian Schiller1, Anne-Marie Bourgault2, Paul Brassard1, Louise Poirier3, François Lamothe4, Claire Béliveau3, Sophie Michaud5, Nathalie Turgeon6, Baldwin Toye7, Eric H Frost5, Rodica Gilca8, Andre Dascal9, Vivian G Loo10. 1. McGill University Health Centre, McGill University, Montréal, QC, Canada. 2. McGill University Health Centre, McGill University, Montréal, QC, Canada; Centre Hospitalier Universitaire de Montréal, Université de Montréal, Montréal, QC, Canada. 3. Centre Hospitalier Universitaire de Montréal, Université de Montréal, Montréal, QC, Canada. 4. Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, QC, Canada. 5. Centre Hospitalier Universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, QC, Canada. 6. Centre Hospitalier Universitaire de Québec-Hôtel-Dieu de Québec, Université Laval, Québec, QC, Canada. 7. Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada. 8. Université Laval, Québec, QC, Canada; Institut national de santé publique du Québec, Québec, QC, Canada. 9. Jewish General Hospital, McGill University, Montréal, QC, Canada. 10. McGill University Health Centre, McGill University, Montréal, QC, Canada. Electronic address: vivian.loo@muhc.mcgill.ca.
Abstract
BACKGROUND: Clostridium difficile (CD) is the leading cause of health care-associated diarrhea and can result in asymptomatic carriage. Rates of asymptomatic CD colonization on hospital admission range from 1.4%-21%. The objective of this study was to evaluate host and bacterial factors associated with colonization on admission. METHODS: The Consortium de recherche québécois sur le Clostridium difficile study provided data for analysis, including demographic information, known risk factors, and potential confounding factors, prospectively collected for 5,232 patients from 6 hospitals in Quebec and Ontario over 15 months from 2006-2007. Stool or rectal swabs were obtained for culture on admission. Pulsed-field gel electrophoresis was performed on the isolates. The presence of antibody against CD toxins A and B was measured. RESULTS: There were 212 (4.05%) patients colonized with CD on admission, and 5,020 patients were not colonized with CD. Multivariate logistic regression analysis showed that hospitalization within the last 12 months, use of corticosteroids, prior CD infection, and presence of antibody against toxin B were associated with colonization on admission. Of patients colonized on admission, 79.4% had non-NAP1, non-NAP2 strains. CONCLUSION: There are identifiable risk factors among asymptomatic CD carriers that could serve in their detection and provide a basis for targeted screening.
BACKGROUND:Clostridium difficile (CD) is the leading cause of health care-associated diarrhea and can result in asymptomatic carriage. Rates of asymptomatic CD colonization on hospital admission range from 1.4%-21%. The objective of this study was to evaluate host and bacterial factors associated with colonization on admission. METHODS: The Consortium de recherche québécois sur le Clostridium difficile study provided data for analysis, including demographic information, known risk factors, and potential confounding factors, prospectively collected for 5,232 patients from 6 hospitals in Quebec and Ontario over 15 months from 2006-2007. Stool or rectal swabs were obtained for culture on admission. Pulsed-field gel electrophoresis was performed on the isolates. The presence of antibody against CD toxins A and B was measured. RESULTS: There were 212 (4.05%) patients colonized with CD on admission, and 5,020 patients were not colonized with CD. Multivariate logistic regression analysis showed that hospitalization within the last 12 months, use of corticosteroids, prior CD infection, and presence of antibody against toxin B were associated with colonization on admission. Of patients colonized on admission, 79.4% had non-NAP1, non-NAP2 strains. CONCLUSION: There are identifiable risk factors among asymptomatic CD carriers that could serve in their detection and provide a basis for targeted screening.
Authors: Hannah C Harris; Emma L Best; Charmaine Normington; Nathalie Saint-Lu; Frédérique Sablier-Gallis; Jean de Gunzburg; Antoine Andremont; Mark H Wilcox; Caroline H Chilton Journal: Antimicrob Agents Chemother Date: 2020-12-16 Impact factor: 5.191
Authors: Zofia Maria Kiersnowska; Ewelina Lemiech-Mirowska; Katarzyna Semczuk; Michał Michałkiewicz; Aleksandra Sierocka; Michał Marczak Journal: Int J Environ Res Public Health Date: 2021-07-01 Impact factor: 3.390