Journal ArticleDOI
Prevalence and diversity of Clostridium difficile strains in infants.
Clotilde Rousseau,Ludovic Lemée,Alban Le Monnier,Isabelle Poilane,Jean-Louis Pons,Anne Collignon +5 more
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TLDR
Results indicate that infants are widely colonized by non-toxigenic strains, which indicates that infants may be a reservoir for adult infectious strains.Abstract:
During early infancy asymptomatic intestinal colonization by Clostridium difficile is frequent. To update information on infant colonization prevalence and to characterize infant strains, in terms of their virulence factors and their phylogenetic diversity, a prospective screening of C. difficile in the stools of infants 0 to 2 years old was conducted at Jean Verdier Hospital (Hopital Jean Verdier) over an 18 month period. C. difficile was screened by toxigenic culture, and molecular characterization was performed by PCR-ribotyping and multilocus sequence typing (MLST). The overall C. difficile colonization prevalence was 33.7 % (99/294). The colonization rate by a toxigenic strain was 7.1 % (21/294). Community-acquired C. difficile accounted for 66.7 % (66/99) of cases. Molecular typing was performed on 90 isolates from Jean Verdier Hospital and 8 additional isolates from another hospital in Versailles (Centre Hospitalier de Versailles). Among these isolates, 23 were toxigenic (21 tcdA+/tcdB
+ and 2 tcdA−/tcdB
+). All the isolates were negative for the binary toxin genes. Seventeen PCR ribotypes (PRs) were identified, with five PRs accounting for 82.7 % (81/98) of the isolates. MLST generated 15 different sequence types (STs). The predominant genotype, PRJV11-ST38 (33.7 %), included only non-toxigenic strains. Toxigenic strains were distributed in eight genotypes. Neither PR027-ST3, nor PR078/126-ST49 were identified but some PRs/STs corresponded to well-known adult infectious strains. These results indicate that infants are widely colonized by non-toxigenic strains. However, toxigenic adult infectious strains circulate in asymptomatic infants even in the community; thus, infants may be a reservoir for adult infectious strains.read more
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Journal ArticleDOI
Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA)
L. Clifford McDonald,Dale N. Gerding,Stuart Johnson,Stuart Johnson,Johan S. Bakken,Karen C. Carroll,Susan E. Coffin,Erik R. Dubberke,Kevin W. Garey,Carolyn V. Gould,Ciaran P. Kelly,Vivian G. Loo,Julia S. Sammons,Thomas J. Sandora,Mark H. Wilcox +14 more
TL;DR: This guideline updates recommendations regarding epidemiology, diagnosis, treatment, infection prevention, and environmental management on Clostridium difficile infection in adults and includes recommendations for children.
Journal ArticleDOI
Guidelines for Diagnosis, Treatment, and Prevention of Clostridium difficile Infections
Christina M. Surawicz,Lawrence J. Brandt,David G. Binion,Ashwin N. Ananthakrishnan,Scott R. Curry,Peter H. Gilligan,Lynne V. McFarland,Mark Mellow,Brian S. Zuckerbraun +8 more
TL;DR: Treatment of patients with CDI should be stratified depending on whether they have mild-to-moderate, severe, or complicated disease, and a classification of disease severity is proposed to guide therapy that is useful for clinicians.
Journal ArticleDOI
Community-acquired Clostridium difficile infection: an increasing public health threat.
Arjun Gupta,Sahil Khanna +1 more
TL;DR: The emerging epidemiology, risk factors, and outcomes for community-acquired C. difficile infection are summarized and clinicians should be aware of factors that predict worse outcomes in order to prevent them.
Journal ArticleDOI
Clostridium difficile Carriage in Healthy Infants in the Community: A Potential Reservoir for Pathogenic Strains
Clotilde Rousseau,Isabelle Poilane,Loic De Pontual,Anne-Claire Maherault,Alban Le Monnier,Anne Collignon +5 more
TL;DR: The dynamics of C. difficile colonization appears mainly as an age-dependent process in asymptomatic infants from the community, who represent a potential reservoir of pathogenic strains.
Journal ArticleDOI
Understanding Clostridium difficile Colonization
Monique J. T. Crobach,Jonathan Vernon,Vivian G. Loo,Ling Yuan Kong,Séverine Péchiné,Mark H. Wilcox,Ed J. Kuijper +6 more
TL;DR: A comprehensive overview of the current understanding of C. difficile colonization among patients at admission is presented, although further research is needed to identify if interventions are beneficial for preventing transmission or overcoming progression to CDI.
References
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TL;DR: Nosocomial C. difficile infection, which was associated with diarrhea in about one third of cases, is frequently transmitted among hospitalized patients and that the organism is often present on the hands of hospital personnel caring for such patients.
Journal ArticleDOI
Production of actin‐specific ADP‐ribosyltransferase (binary toxin) by strains of Clostridium difficile
Simon L. J. Stubbs,Maja Rupnik,Maryse Gibert,Jon S. Brazier,Brian I. Duerden,Michel R. Popoff +5 more
TL;DR: Results indicate that 6.4% of toxigenic isolates of C. difficile referred to the Anaerobe Reference Unit from UK hospitals have cdtA and cdtB genes.
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