Clostridium difficile carriage in adult cystic fibrosis (CF); implications for patients with CF and the potential for transmission of nosocomial infection

被引：23

作者：

Burke, D. G. ^{[1
]}

Harrison, M. J. ^{[2
]}

Fleming, C. ^{[2
]}

McCarthy, M. ^{[2
]}

Shortt, C. ^{[2
]}

Sulaiman, I. ^{[3
]}

Murphy, D. M. ^{[2
]}

Eustace, J. A. ^{[4
]}

Shanahan, F. ^{[1
]}

Hill, C. ^{[5
]}

Stanton, C. ^{[6
]}

Rea, M. C. ^{[6
]}

Ross, R. P. ^{[1
]}

Plant, B. J. ^{[7
]}

机构：

[1] Univ Coll Cork, AFC Microbiome Inst, Cork, Ireland

[2] Univ Coll Cork, Cork Adult CF Ctr, Dept Resp Med, Cork Univ Hosp, Cork, Ireland

[3] Univ Coll Cork, Dept Resp Med, Cork Univ Hosp, Cork, Ireland

[4] Univ Coll Cork, Hlth Res Board, Clin Res Facil, Cork, Ireland

[5] Univ Coll Cork, Sch Microbiol, Cork, Ireland

[6] Teagasc Food Res Ctr, Moorepk, Fermoy, Cork, Ireland

[7] Univ Coll Cork, Cork Univ Hosp, Dept Med, Cork Adult CF Ctr, Cork, Ireland

来源：

JOURNAL OF CYSTIC FIBROSIS | 2017年 / 16卷 / 02期

基金：

爱尔兰科学基金会;

关键词：

Clostridium difficile; Cystic fibrosis; Transmission; Nosocomial infection; PULMONARY EXACERBATIONS; RISK-FACTORS; HOSPITALIZED-PATIENTS; DISEASE; ACQUISITION; COLITIS; SUPPLEMENTATION; METRONIDAZOLE; ANTIBIOTICS; CARRIERS;

D O I：

10.1016/j.jcf.2016.09.008

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Clostridium difficile is an anaerobic Gram-positive, spore-forming, toxin-producing bacillus transmitted among humans through the faecal oral route. Despite increasing carriage rates and the presence of C. dfficile toxin in stool, patients with CF rarely appear to develop typical manifestations of C. dfficile infection (CDT). In this study, we examined the carriage, toxin production, ribotype distribution and antibiotic susceptibility of C. difficile in a cohort of 60 adult patients with CF who were pre-lung transplant. C. dfficile was detected in 50% (30/60) of patients with CF by culturing for the bacteria. C. dicile toxin was detected in 63% (19/30) of C. dffficik-positive stool samples. All toxin-positive stool samples contained toxigenic C. dfficile strains harbouring toxin genes, tcdA and tcdB. Despite the presence of C. dlcile and its toxin in patient stool, no acute gastrointestinal symptoms were reported. Ribotyping of C. difficile strains revealed 16 distinct ribotypes (RT), 11 of which are known to be disease-causing including the hyper-virulent RT078. Additionally, strains RT002, RT014, and RT015, which are common in non-CF nosocomial infection were described. All strains were susceptible to vancomycin, metronidnzole, fusidic acid and rifampicin. No correlation was observed between carriage of C. dijficile or. any characteristics of isolated strains and any recorded clinical parameters or treatment received. We demonstrate a high prevalence of hypervirulent, toxigenic strains of C. dlcile in asymptomatic patients with CF. This highlights the potential role of asymptomatic patients with CF in nosocomial transmission of C. dfficile. (C) 2016 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

引用

页码：291 / 298

页数：8

共 55 条

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