One-day prevalence of asymptomatic carriage of toxigenic and non-toxigenic Clostridioides difficile in 10 French hospitals.
Asymptomatic carriage
Clostridioides difficile
One-day prevalence study
Risk factors
Journal
The Journal of hospital infection
ISSN: 1532-2939
Titre abrégé: J Hosp Infect
Pays: England
ID NLM: 8007166
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
received:
16
02
2022
revised:
02
05
2022
accepted:
02
05
2022
pubmed:
1
6
2022
medline:
27
10
2022
entrez:
31
5
2022
Statut:
ppublish
Résumé
Asymptomatic faecal carriage of Clostridioides difficile has been widely evaluated, but its prevalence across a wide range of clinical departments and related risk factors are not well described. The objectives of the PORTADIFF study were to evaluate the prevalence and identifying risk factors leading to asymptomatic carriage of both toxigenic and non-toxigenic C. difficile. The PORTADIFF study was a 1-day prevalence study carried out in 10 different French hospitals. Adult patients, who agreed to participate, were included in this study and provided a fresh stool sample. C. difficile strains isolated from carriage were characterized by polymerase chain reaction (PCR) detection of tcdA, tcdB, cdtA and cdtB, and PCR ribotyping. In total, 721 patients were included in this study. The median age was 73 years (range 18-101 years) and the male/female ratio was 1.06. C. difficile (either toxigenic or non-toxigenic strains) was isolated from 79 (11%) patients; 42 (5.8%) strains were toxigenic. The prevalence rates of asymptomatic carriage ranged from 5% on surgical wards to 19% on long-term care wards. The main risk factors associated with asymptomatic carriage were antibiotic treatment within the preceding 3 months (81.8% vs 53.7%; P<0.01), hospitalization within the preceding 2 months (55.8% vs 33%; P<0.01), cumulative duration of hospital stay before study inclusion (mean 50.1 vs 34.5 days; P<0.047), and hospitalization on a ward with high global incidence of C. difficile infection. Eleven percent of hospitalized patients were asymptomatic carriers of toxigenic or non-toxigenic C. difficile, and may constitute a potential reservoir of C. difficile strains.
Sections du résumé
BACKGROUND
BACKGROUND
Asymptomatic faecal carriage of Clostridioides difficile has been widely evaluated, but its prevalence across a wide range of clinical departments and related risk factors are not well described. The objectives of the PORTADIFF study were to evaluate the prevalence and identifying risk factors leading to asymptomatic carriage of both toxigenic and non-toxigenic C. difficile.
METHODS
METHODS
The PORTADIFF study was a 1-day prevalence study carried out in 10 different French hospitals. Adult patients, who agreed to participate, were included in this study and provided a fresh stool sample. C. difficile strains isolated from carriage were characterized by polymerase chain reaction (PCR) detection of tcdA, tcdB, cdtA and cdtB, and PCR ribotyping.
RESULTS
RESULTS
In total, 721 patients were included in this study. The median age was 73 years (range 18-101 years) and the male/female ratio was 1.06. C. difficile (either toxigenic or non-toxigenic strains) was isolated from 79 (11%) patients; 42 (5.8%) strains were toxigenic. The prevalence rates of asymptomatic carriage ranged from 5% on surgical wards to 19% on long-term care wards. The main risk factors associated with asymptomatic carriage were antibiotic treatment within the preceding 3 months (81.8% vs 53.7%; P<0.01), hospitalization within the preceding 2 months (55.8% vs 33%; P<0.01), cumulative duration of hospital stay before study inclusion (mean 50.1 vs 34.5 days; P<0.047), and hospitalization on a ward with high global incidence of C. difficile infection.
CONCLUSION
CONCLUSIONS
Eleven percent of hospitalized patients were asymptomatic carriers of toxigenic or non-toxigenic C. difficile, and may constitute a potential reservoir of C. difficile strains.
Identifiants
pubmed: 35640734
pii: S0195-6701(22)00162-1
doi: 10.1016/j.jhin.2022.05.011
pii:
doi:
Substances chimiques
Bacterial Toxins
0
Anti-Bacterial Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
65-74Investigateurs
C Hartmann
(C)
A Kazhalawi
(A)
S Lambert-Bordes
(S)
S Bleunven
(S)
J-P Bedos
(JP)
A Greder-Belan
(A)
S Rigaudea
(S)
H Lecuyer
(H)
A Jousset
(A)
D Lebeaux
(D)
B Levy
(B)
C Rabate
(C)
A Collignon
(A)
J Batah
(J)
V Francois
(V)
G Sebbane
(G)
P-L Woerther
(PL)
G Loggia
(G)
J Michon
(J)
R Verdon
(R)
D Samba
(D)
J-B Méar
(JB)
T Guillard
(T)
Y Nguyen
(Y)
F Banisadr
(F)
A Delmer
(A)
C Himberlin
(C)
S Diallo
(S)
I Furet
(I)
B Achouri
(B)
A Reksa
(A)
S Jouveshomme
(S)
E Menage
(E)
F Philippart
(F)
M Hadj-Abdeslam
(M)
B Durand-Gasselin
(B)
M Eveillard
(M)
A Kouatchet
(A)
A Schmidt
(A)
C Salanoubat
(C)
M-N Heurtaux
(MN)
P Cronier
(P)
A Foufa
(A)
Informations de copyright
Copyright © 2022 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.