ArticleBMC infectious diseases2016
Colonization of toxigenic Clostridium difficile among ICU patients: a prospective study.
Article in BMC infectious diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Review
- Clostridioides difficile colonization amplification despite limited in-hospital transmission: A modeling study.PLoS medicine · 2026Article
- Impact of targeted interventions on healthcare-acquired infection prevention and control of Clostridium difficile infections.Antimicrobial resistance and infection control · 2025Article
- Heterogeneity of Clostridioides difficile asymptomatic colonization prevalence: a systematic review and meta-analysis.Gut pathogens · 2025Article
- [Analysis ofNan fang yi ke da xue xue bao = Journal of Southern Medical University · 2024Article
- Comparative Whole Genome Sequence Analysis and Biological Features ofFrontiers in microbiology · 2021Article
- Evidence of transmission of Clostridium difficile in asymptomatic patients following admission screening in a tertiary care hospital.PloS one · 2019Article
- Understanding Clostridium difficile Colonization.Clinical microbiology reviews · 2018Review
- Article
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6 authors.
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Abstract
backgroundA prospective study was performed to investigate the prevalence of colonization among ICU patients and to examine whether asymptomatic carriers were the source of subsequent C. difficile infection (CDI) and acquisition of toxigenic C. difficile.
methodsRectal swabs were collected from adult patients on admission to and at discharge from a 50-bed medical ICU of a major referral hospital in western China, from August to November 2014. Stools were collected from patients who developed ICU-onset diarrhea. Both swabs and stools were screened for tcdB (toxin B gene) by PCR. Samples positive to tcdB were cultured for C. difficile and isolates recovered were screened for tcdB and the binary toxin genes by PCR. Strain typing was performed using multilocus sequence typing and isolates belonging to the same sequence type (ST) were further typed using multiple-locus variable number tandem repeat analysis (MLVA).
resultsDuring the 4-month period, rectal swabs were collected from 360 (90.9 %) out of 396 patients who were admitted to the ICU. Among the 360 patients, 314 had stayed in the ICU more than 3 days, of which 213 (73.6 %) had a rectal swab collected within the 3 days prior to discharge from ICU. The prevalence of toxigenic C. difficile colonization was 1.7 % (6 cases) and 4.3 % (10 cases) on admission and discharge, respectively. Only four (1.1 %) out of 360 patients had CDI, corresponding to 10.7 cases per 10,000 ICU days. None of the four cases had toxigenic C. difficile either on admission or at discharge. Toxigenic C. difficile isolates were recovered from all swabs and stool samples positive for tcdB by PCR and belonged to 7 STs (ST2, 3, 6, 37, 54, 103 and 129). None of the isolates belonging to the same ST had identical MLVA patterns. Binary toxin genes were detected in one ST103 isolate that caused colonization.
conclusionThe prevalence of colonization with toxigenic C. difficile among patients on admission to ICU was low in our setting. ICU-acquired toxigenic C. difficile were not linked to those detected on admission. Active screening for toxigenic C. difficile may not be a resource-efficient measure in settings with a low prevalence of colonization.
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