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703. Prevalence of Toxigenic and Non-Toxigenic C. difficile in Patients Admitted to an Academic-Affiliated Long Term Acute Care Hospital
BACKGROUND: Clostridioides difficile (C. difficile) is the leading hospital associated infection and is highly prevalent among patients admitted to long term care facilities (LTCFs). Both toxigenic and non-toxigenic strains of C. difficile colonize patients and produce spores that can persist on hea...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10679204/ http://dx.doi.org/10.1093/ofid/ofad500.765 |
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author | Strudwick, Amanda F Suchindran, Deepti Lohsen, Sarah Clark, Barry Whatley, Jeffery D Triolo, Bella Evans, David Liakakos, Haley Alperstein, Jack Page, Alex Satola, Sarah W Acharya, Adhikar Grooms, Lori A Babiker, Ahmed Woodworth, Michael H |
author_facet | Strudwick, Amanda F Suchindran, Deepti Lohsen, Sarah Clark, Barry Whatley, Jeffery D Triolo, Bella Evans, David Liakakos, Haley Alperstein, Jack Page, Alex Satola, Sarah W Acharya, Adhikar Grooms, Lori A Babiker, Ahmed Woodworth, Michael H |
author_sort | Strudwick, Amanda F |
collection | PubMed |
description | BACKGROUND: Clostridioides difficile (C. difficile) is the leading hospital associated infection and is highly prevalent among patients admitted to long term care facilities (LTCFs). Both toxigenic and non-toxigenic strains of C. difficile colonize patients and produce spores that can persist on healthcare surfaces. Prior trials have shown that administration of non-toxigenic C. difficile can reduce recurrent C. difficile infection (CDI). We sought to estimate the prevalence of toxigenic and non-toxigenic C. difficile in a LTCF as a step toward better understanding if colonization with non-toxigenic C. difficile may be protective for CDI. METHODS: Patients admitted to an academic-affiliated long-term acute care facility (or their legally authorized representatives) were approached for verbal consent for collection of peri-rectal, inguinal swabs, and an environmental surface composite swab that were cultured in CCMB-TAL, a differential and selective media for C. difficile. Positive cultures underwent nucleic acid extraction and PCR with primers designed to amplify a pan-C. difficile target (rplB), C. difficile toxin (tcdB) and the conserved non-coding region carried by non-toxigenic strains instead of the Pathogenicity Locus. RESULTS: Of 43 occupied LTCF rooms, a total of 32/43 (74.4%) participants were sampled on two floors on one day. The Standard Infection Ratio (SIR) for C.difficile in the two quarters prior to sampling were 1.12 and 1.17, at the LTCF. At least one C. difficile strain was detected in 8/32 (25%) sampled patients (Fig. 1A). The estimated prevalence of toxigenic C. difficile was 5/32 (15.6%). (Fig. 1B, 1D). The estimated prevalence of non-toxigenic C. difficile was 5/32 (15.6%) (Fig. 1C, 1D). PCR-based detection of both tcdB and the conserved locus in non-toxigenic strains suggested mixed colonization with toxigenic and non-toxigenic strains in 2/32 (6.2%) patients. [Figure: see text] [Figure: see text] [Figure: see text] CONCLUSION: These data demonstrate that both toxigenic and non-toxigenic strains of C. difficile are prevalent in long-term care hospital patients but mixed colonization with both strains is less frequent. Further investigations are needed to determine the relationship between non-toxigenic C. difficile prevalence and risk of C. difficile infection recurrence. [Figure: see text] DISCLOSURES: Ahmed Babiker, MBBS, Roche: Advisor/Consultant |
format | Online Article Text |
id | pubmed-10679204 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-106792042023-11-27 703. Prevalence of Toxigenic and Non-Toxigenic C. difficile in Patients Admitted to an Academic-Affiliated Long Term Acute Care Hospital Strudwick, Amanda F Suchindran, Deepti Lohsen, Sarah Clark, Barry Whatley, Jeffery D Triolo, Bella Evans, David Liakakos, Haley Alperstein, Jack Page, Alex Satola, Sarah W Acharya, Adhikar Grooms, Lori A Babiker, Ahmed Woodworth, Michael H Open Forum Infect Dis Abstract BACKGROUND: Clostridioides difficile (C. difficile) is the leading hospital associated infection and is highly prevalent among patients admitted to long term care facilities (LTCFs). Both toxigenic and non-toxigenic strains of C. difficile colonize patients and produce spores that can persist on healthcare surfaces. Prior trials have shown that administration of non-toxigenic C. difficile can reduce recurrent C. difficile infection (CDI). We sought to estimate the prevalence of toxigenic and non-toxigenic C. difficile in a LTCF as a step toward better understanding if colonization with non-toxigenic C. difficile may be protective for CDI. METHODS: Patients admitted to an academic-affiliated long-term acute care facility (or their legally authorized representatives) were approached for verbal consent for collection of peri-rectal, inguinal swabs, and an environmental surface composite swab that were cultured in CCMB-TAL, a differential and selective media for C. difficile. Positive cultures underwent nucleic acid extraction and PCR with primers designed to amplify a pan-C. difficile target (rplB), C. difficile toxin (tcdB) and the conserved non-coding region carried by non-toxigenic strains instead of the Pathogenicity Locus. RESULTS: Of 43 occupied LTCF rooms, a total of 32/43 (74.4%) participants were sampled on two floors on one day. The Standard Infection Ratio (SIR) for C.difficile in the two quarters prior to sampling were 1.12 and 1.17, at the LTCF. At least one C. difficile strain was detected in 8/32 (25%) sampled patients (Fig. 1A). The estimated prevalence of toxigenic C. difficile was 5/32 (15.6%). (Fig. 1B, 1D). The estimated prevalence of non-toxigenic C. difficile was 5/32 (15.6%) (Fig. 1C, 1D). PCR-based detection of both tcdB and the conserved locus in non-toxigenic strains suggested mixed colonization with toxigenic and non-toxigenic strains in 2/32 (6.2%) patients. [Figure: see text] [Figure: see text] [Figure: see text] CONCLUSION: These data demonstrate that both toxigenic and non-toxigenic strains of C. difficile are prevalent in long-term care hospital patients but mixed colonization with both strains is less frequent. Further investigations are needed to determine the relationship between non-toxigenic C. difficile prevalence and risk of C. difficile infection recurrence. [Figure: see text] DISCLOSURES: Ahmed Babiker, MBBS, Roche: Advisor/Consultant Oxford University Press 2023-11-27 /pmc/articles/PMC10679204/ http://dx.doi.org/10.1093/ofid/ofad500.765 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Abstract Strudwick, Amanda F Suchindran, Deepti Lohsen, Sarah Clark, Barry Whatley, Jeffery D Triolo, Bella Evans, David Liakakos, Haley Alperstein, Jack Page, Alex Satola, Sarah W Acharya, Adhikar Grooms, Lori A Babiker, Ahmed Woodworth, Michael H 703. Prevalence of Toxigenic and Non-Toxigenic C. difficile in Patients Admitted to an Academic-Affiliated Long Term Acute Care Hospital |
title | 703. Prevalence of Toxigenic and Non-Toxigenic C. difficile in Patients Admitted to an Academic-Affiliated Long Term Acute Care Hospital |
title_full | 703. Prevalence of Toxigenic and Non-Toxigenic C. difficile in Patients Admitted to an Academic-Affiliated Long Term Acute Care Hospital |
title_fullStr | 703. Prevalence of Toxigenic and Non-Toxigenic C. difficile in Patients Admitted to an Academic-Affiliated Long Term Acute Care Hospital |
title_full_unstemmed | 703. Prevalence of Toxigenic and Non-Toxigenic C. difficile in Patients Admitted to an Academic-Affiliated Long Term Acute Care Hospital |
title_short | 703. Prevalence of Toxigenic and Non-Toxigenic C. difficile in Patients Admitted to an Academic-Affiliated Long Term Acute Care Hospital |
title_sort | 703. prevalence of toxigenic and non-toxigenic c. difficile in patients admitted to an academic-affiliated long term acute care hospital |
topic | Abstract |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10679204/ http://dx.doi.org/10.1093/ofid/ofad500.765 |
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