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Prospective study of Clostridium difficile colonization and para-cresol detection in the stools of babies on a special care unit

Published online by Cambridge University Press:  19 October 2009

T. J. Phua ,
T. R. Rogers  and
A. P. Pallett
T. J. Phua
Affiliation:
Department of Medical Microbiology, Westminster Medical School, Horseferry Road, London SWAP 2AR, U.K.
T. R. Rogers*
Affiliation:
Department of Medical Microbiology, Westminster Medical School, Horseferry Road, London SWAP 2AR, U.K.
A. P. Pallett
Affiliation:
Department of Medical Microbiology, Westminster Medical School, Horseferry Road, London SWAP 2AR, U.K.
*
*For correspondence
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Infants' stools were examined for the presence of Clostridium difficile and its cytotoxin in a study performed over a one-year period on a special care baby unit. Overall, 21% of infants were colonized, but the organism was only recovered in a seven-month period during which its weekly prevalence in the group varied from zero to 44%, with a distinct clustering of colonized infants being observed. Tests for the presence of cytotoxin in the stools and in supernatants of broth that had been inoculated with each isolate were negative. The factors predisposing to colonization were a prolonged stay in the unit, low birth weight, younger gestational age and being nursed in an incubator. The organism was recovered only once from an environmental screen.

An antibiogram, used in conjunction with toxin production, was helpful in distinguishing these isolates from a collection obtained from other units in the hospital. We conclude that Cl. difficile was acquired by nosocomial spread although we did not establish the precise mechanism involved.

The detection of para-cresol by gas–liquid chromatography was found to be specific but insufficiently sensitive as a screening test for the organism's presence in the stools. It could only be demonstrated in infants whose birth-weights were less than 2500 g, and no association was observed between the type of feed and para-cresol presence in stools.

Type
Research Article
Information
Journal of Hygiene , Volume 93 , Issue 1 , August 1984 , pp. 17 - 25
Copyright
Copyright © Cambridge University Press 1984

References

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