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Clostridium difficile O27 colitis: Hospital-onset but community-acquired

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Abstract

Large outbreaks of Clostridium difficile (CD) associated colitis in North America and Europe have been attributed to the emergence of the epidemic/toxin PCR Ribotype O27 CD strain (CD027). Due to the increased virulence of this epidemic strain and its propension for causing outbreaks, we performed a structured risk-assessment approach in order to determine the risks associated with the introduction of this strain within our university hospital. From February 2009 to January 2010, we identified 31 cases of CD027 associated colitis, whereby twenty one (67.7%) had symptoms onset more than 48 hours after admission and were classified as nosocomial. These patients had received wide-spectrum antimicrobials for other infections in the hospital before CD027 colitis diagnosis. The 31 patients with CD027 were admitted in 20 different units, managed by distinct health-care workers (HCWs), and no contact was identified between patients during their hospital stay. Furthermore, infection control audits showed 100% compliance with institutional guidelines for control of CD colitis. These findings suggest that CD027 is most frequently acquired in the community and emerges sporadically under antibiotic pressure during hospitalization.

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Acknowledgements

Special thanks to the patients, to the infection control nurses and to all the staff who participated in the study and consciously implemented infection control procedures in the affected departments.

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Authors and Affiliations

  1. Unité d’Hygiène Hospitalière, Pôle Microorganismes, CHU Rennes, 35033, Rennes, France

    S. Buffet-Bataillon & M. Cormier

  2. Service de maladies infectieuses et réanimation médicale, CHU Rennes, 35033, Rennes, France

    P. Tattevin

  3. CCLIN Ouest, Hôpital de l’Hôtel-Dieu, CHU Rennes, 35033, Rennes, France

    H. Sénéchal

  4. Laboratoire de bactériologie, Pôle Microorganismes, CHU Rennes, 35033, Rennes, France

    P. Vincent

  5. Univ Rennes1, UPRES-EA 1254, 35043, Rennes, France

    M. Cormier & P. Vincent

  6. Unité d’Hygiène, Hôpital Pontchaillou, 2 rue Henri Le Guilloux, 35033, Rennes, France

    S. Buffet-Bataillon

Authors
  1. S. Buffet-Bataillon
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  2. P. Tattevin
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  3. H. Sénéchal
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  4. M. Cormier
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  5. P. Vincent
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Correspondence to S. Buffet-Bataillon.

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Buffet-Bataillon, S., Tattevin, P., Sénéchal, H. et al. Clostridium difficile O27 colitis: Hospital-onset but community-acquired. Eur J Clin Microbiol Infect Dis 31, 2263–2267 (2012). https://doi.org/10.1007/s10096-012-1565-2

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  • DOI: https://doi.org/10.1007/s10096-012-1565-2

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