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Asymptomatic carriage of Clostridium difficile in an Irish continuing care institution for the elderly: prevalence and characteristics

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Abstract

Introduction

Clostridium difficile is an increasing cause of nosocomial diarrhoea and colitis. The aim of this study was to identify the prevalence and characteristics of asymptomatic C. difficile carriage in a continuing care institution for the elderly.

Methods

Stool samples were collected from 100 asymptomatic patients, whose median age was 83 years. Samples were tested for C. difficile using traditional culturing methods, 16s rDNA and 16s–23s intergenic spacer (IGS) rDNA sequencing, and analysed for toxin production and toxin genes.

Results

The prevalence of C. difficile carriage was 10/100 (10%) following culture and 16s and IGS sequencing. An additional seven isolates, initially identified as C. difficile, were subsequently identified by IGS rDNA sequencing as C. sordellii of the 10% that tested positive for C. difficile, seven tested positive for toxin A and B. A significant number of C. difficile carriers had recent antibiotic exposure compared with non-carriers, P = 0.046.

Conclusion

The prevalence of asymptomatic C. difficile carriage in this institution was 10%, 7% of which were toxin positive. This study underscores the importance of increased vigilance for C. difficile using microbial and molecular methodology and identifies patients at increased risk following antibiotic administration.

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Acknowledgments

The authors wish to acknowledge the assistance of the geriatricians of St Finbarr’s hospital for facilitating access to their patients and the role of the nursing staff in the collection of specimens and the patients who contributed to the study.

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Authors and Affiliations

  1. 4.31 Alimentary Pharmabiotic Centre, Biosciences Institute, University College Cork, College Road, Cork, Ireland

    J. Ryan, B. Sheil & F. Shanahan

  2. Alimentary Health Ltd, Cork, Ireland

    C. Murphy, J. MacSharry & F. Shanahan

  3. St Finbarr’s Hospital, Cork, Ireland

    C. Twomey

  4. Moorepark Food Research Centre, Teagasc, Fermoy, Co. Cork, National University of Ireland Cork, Cork, Ireland

    R. Paul Ross & M. C. Rea

Authors
  1. J. Ryan
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  2. C. Murphy
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  3. C. Twomey
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  4. R. Paul Ross
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  5. M. C. Rea
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  6. J. MacSharry
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  7. B. Sheil
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  8. F. Shanahan
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Correspondence to B. Sheil.

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Ryan, J., Murphy, C., Twomey, C. et al. Asymptomatic carriage of Clostridium difficile in an Irish continuing care institution for the elderly: prevalence and characteristics. Ir J Med Sci 179, 245–250 (2010). https://doi.org/10.1007/s11845-009-0361-1

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  • DOI: https://doi.org/10.1007/s11845-009-0361-1

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