Colonization by Clostridium difficile of neonates in a hospital, and infants and children in three day-care facilities of Kanazawa, Japan

Authors

  • Shinichirou Matsuki Department of Laboratory Science, School of Health Sciences, Kanazawa University, Japan
  • Eijiro Ozaki Department of Bacteriology, Graduate School of Medical Science, Kanazawa, Japan
  • Makio Shozu Center for Perinatal and Reproductive Health, Kanazawa University Hospital, Japan
  • Masaki Inoue Center for Perinatal and Reproductive Health, Kanazawa University Hospital, Japan
  • Shouji Shimizu Department of Serology, Kanazawa Medical University, Japan
  • Nobuo Yamaguchi Department of Serology, Kanazawa Medical University, Japan
  • Tadahiro Karasawa Department of Laboratory Science, School of Health Sciences, Kanazawa University, Japan
  • Takayoshi Yamagishi Department of Laboratory Science, School of Health Sciences, Kanazawa University, Japan
  • Shinichi Nakamura Department of Bacteriology, Graduate School of Medical Science, Kanazawa, Japan

Keywords:

Clostridium difficile, bacterial colonization, carriage rate, molecular typing⋅ neonates, infants, children

Abstract

The intestinal-carriage rates of i>Clostridium difficile in neonates hospitalized in the University Hospital’s Center for Perinatal and Reproductive Health and in infants and children enrolled in two day-nurseries and a kindergarten were examined. Swab samples from the floors of these facilities were also analyzed to determine the extent of environmental contamination by this organism. C. difficile was found in the stool of only one of 40 neonates during the normal 1-week stay in the hospital after delivery. The isolate from the neonate was identical to that of her mother, as determined by PCR ribotyping, pulsed-field gel electrophoresis analysis, and toxin gene type, suggesting that the C. difficile-positive neonate acquired the organism from her mother rather than from the environment. By contrast, 47 (48.0%) of the 98 infants and children, comprising 50 enrolled in two daynurseries who were ≤3 years old and 48 enrolled in a kindergarten who were 2–5 years old, carried C. difficile. The carriage rate in infants under 2 years of age was much higher (84.4%) than in children 2 years old and older (30.3%). When analyzed according to age group, the carriage rates were 100, 75.0, 45.5, 24.0, 38.5, and 23.5% in infants and children 0, 1, 2, 3, 4, and 5 years old, respectively. The observation that several children were colonized with the same type of C. difficile strain in each day-care facility, and that the floors of day-nursery A and kindergarten C were contaminated with C. difficile strains identical to those colonizing the intestines of children enrolled in those facilities suggests that cross-infection of C. difficile among children occurs through C. difficile-carrying children or their contaminated environments. [Int Microbiol 2005; 8(1):43-48]

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Published

2010-02-27

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Section

Research Articles