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Clostridium difficile prevalence rates in a large healthcare system stratified according to patient population, age, gender, and specimen consistency

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Abstract

We evaluated Clostridium difficile prevalence rates in 2,807 clinically indicated stool specimens stratified by inpatient (IP), nursing home patient (NH), outpatient (OP), age, gender, and specimen consistency using bacterial culture, toxin detection, and polymerase chain reaction (PCR) ribotyping. Rates were determined based on the detection of toxigenic C. difficile isolates. We identified significant differences in the rates between patient populations and with age. Specimens from NH had a higher rate (46%) for toxigenic C. difficile than specimens from IP (18%) and OP (17%). There were no gender-related differences in the rates. Liquid specimens had a lower rate (15%) than partially formed and soft specimens (25%) and formed specimens (18%) for the isolation of toxigenic C. difficile. The nontoxigenic rate was lowest for NH (4%) and highest for patients <20 years of age (23%). We identified 31 different toxigenic ribotypes from a sampling of 190 isolates that showed the lowest diversity in NH. Fluoroquinolone resistance was observed in 93% of the 027 isolates, all of the 053 isolates, and in four other ribotypes. We observed different rates for toxigenic C. difficile in stratified patient populations, with the highest rate for NH, a low overall nontoxigenic rate, and fluoroquinolone resistance.

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Acknowledgments

We are grateful to Dale Grgurich, MBA, MT, Louise Henry, MT, and Callie Hill, MT of Solstas Lab Partners at Carilion Clinic, Roanoke, VA, USA, for their contributions to this study.

Funding for this study was supplied by TechLab, Inc., Virginia Tech Corporate Research Park, Blacksburg, VA, USA.

Conflict of interest

The authors of this paper include scientists of TechLab, Inc., and, alone, are responsible for the content and the writing of the paper.

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Authors and Affiliations

  1. Research and Development, TechLab, Inc., 2001 Kraft Drive, Blacksburg, VA, 24060, USA

    J. H. Boone, M. Goodykoontz, S. J. Rhodes, K. Price, J. Smith, K. N. Gearhart, R. J. Carman, T. D. Wilkins & D. M. Lyerly

  2. Division of Infectious Disease, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA

    T. M. Kerkering

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  1. J. H. Boone
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  2. M. Goodykoontz
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  3. S. J. Rhodes
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  4. K. Price
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  5. J. Smith
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  6. K. N. Gearhart
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  7. R. J. Carman
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  9. T. D. Wilkins
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  10. D. M. Lyerly
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Correspondence to D. M. Lyerly.

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Boone, J.H., Goodykoontz, M., Rhodes, S.J. et al. Clostridium difficile prevalence rates in a large healthcare system stratified according to patient population, age, gender, and specimen consistency. Eur J Clin Microbiol Infect Dis 31, 1551–1559 (2012). https://doi.org/10.1007/s10096-011-1477-6

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  • DOI: https://doi.org/10.1007/s10096-011-1477-6

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