No abstract

SUMMARY Rectal swabs from 122 patients and 497 environmental swabs from several wards were examined for the presence of Clostridium difficile in order to assess the role of the environment in the spread of this organism. Clostridium difficile was isolated from 6/27 (22-2%) oncology patients and from 8/163 (4 9%) environmental specimens obtained from the oncology unit. Items found positive for C difficile were those subjected to faecal contamination such as commode chairs, bed pans, dust pans, discard bins, the sluice and a disposable bed pan machine.Fourteen of 51 (27-4%) asymptomatic neonates yielded mostly toxigenic C difficile in their stools during their first week of life. Five of 156 (3-2%) specimens taken from inanimate objects in the environment of the neonatal units were positive for C difficile. The organism was also isolated from the hands of a nurse.Similar antibiogram patterns were demonstrated in the strains obtained from the patients and their environment indicating the possible occurrence of cross infection.These results indicate that environmental contamination is important in the spread of C difficile in hospitalised patients and the implementation of isolation procedures may limit that spread.

No abstract

SUMMARYA total of 2525 strains of Escherichia coli were isolated from the faeces of 33 mothers, the faeces of their babies and the mucus extracted from the babies' mouths after delivery. Of these strains 1832 could be 0-serotyped with 150 0 antisera. E. coli were isolated from 28 babies and the same serotypes as were found in their mothers were found in 22 of them. E. coli was isolated from only 14 of the mucus specimens but in 12 of these at least one of the serotypes present was subsequently found in the babies' stools.

A typing method for Clostridium difficile based on the incorporation of [35S]methionine into cellular proteins, their separation by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and their visualization by autoradiography is described. On analysis of the radiolabeled-protein profiles, nine distinct groups were observed (A to E and W to Z). The method, which is simple, reproducible, and readily expandable, has been applied in epidemiological studies to demonstrate cross-infection and hospital acquisition of C. ditficile. The epidemiology of Clostridiium difficile diarrheal disease has not yet been fully clarified. Although C. difficile is known to be the primary cause of pseudomembranous colitis and antibiotic-associated colitis (AAC) and is associated with diarrhea after antibiotic therapy and chemotherapy (1, 8, 10, 11), this organism has also been isolated from the feces of healthy adults (0 to 11%) (1, 3, 12), from vaginal specimens of healthy mothers (18%) (18), and from asymptomatic infants and neonates (40 to 75%) (4, 7, 12, 15, 18). Although reports of clustering of cases and outbreaks of pseudomembranous colitis and AAC are suggestive of the nosocomial