Clinical and microbiological features of Clostridium difficile infections in France: The ICD-RAISIN 2009 national survey

Eckert, Catherine; Coignard, B.; Hebert, Marjolaine; Tarnaud, Chloé; Tessier, Claude; Lemire, Astrid; Burghoffer, Béatrice; Noël, Delphine; Barbut, Frédéric

doi:10.1016/j.medmal.2013.01.004

Cited by 58 publications

(41 citation statements)

References 28 publications

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“…One of two bacteremia cases recently reported by Hemminger et al was due to the epidemic and hypervirulent NAP1 strain (027/BI, toxinotype III, binary toxin-positive), and the other was due to NAP-4 [49]. In the present series, Case 2 was due to a strain of ribotype 078/126 which is one of the ribotypes most frequently found in France [50]. So far, there is no evidence indicating that one specific ribotype may be more often responsible for CDB than another.…”

Section: Systematic Reviewsupporting

confidence: 53%

Clostridium difficile bacteremia: Report of two cases in French hospitals and comprehensive review of the literature

Doufair

Eckert

Drieux

et al. 2017

IDCases

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We report two cases of bacteremia due to Clostridium difficile from two French hospitals. The first patient with previously diagnosed rectal carcinoma underwent courses of chemotherapy, and antimicrobial treatment, and survived the C. difficile bacteremia. The second patient with colon perforation and newly diagnosed lung cancer underwent antimicrobial treatment in an ICU but died shortly after the episode of C. difficile bacteremia. A review of the literature allowed the identification of 137 cases of bacteremia between July 1962 and November 2016. Advanced age, gastro-intestinal disruption, severe underlying diseases and antimicrobial exposure were the major risk factors for C. difficile bacteremia. Antimicrobial therapy was primarily based on metronidazole and/or vancomycin. The crude mortality rate was 35% (21/60).

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Section: Systematic Reviewsupporting

confidence: 53%

Clostridium difficile bacteremia: Report of two cases in French hospitals and comprehensive review of the literature

Doufair

Eckert

Drieux

et al. 2017

IDCases

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“…The results of a literature search support the associations of specific PRs between infants and adult patients in other countries, namely, PR 014 in France (12,38) and PR 001 in Sweden (23,39). The possibility of direct transmission of specific strains from asymptomatic babies to their mothers, who then suffer recurrent CDI, has been reported (14), although this form of transmission remains speculative.…”

Section: Fig 3 Longitudinal Changes In Bacterial Counts and Genotypesmentioning

confidence: 57%

Longitudinal Investigation of Carriage Rates, Counts, and Genotypes of Toxigenic Clostridium difficile in Early Infancy

Kubota

Makino

Gawad³

et al. 2016

Appl Environ Microbiol

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Asymptomatic infant carriers of toxigenic Clostridium difficile are suggested to play a role in the transmission of C. difficile infection (CDI) in adults. However, the mode of C. difficile carriage in infants remains to be fully elucidated. We investigated longitudinal changes in carriage rates, counts, and strain types of toxigenic C. difficile in infants. Stools collected from 111 healthy infants in Belgium periodically from birth until the age of 6 months were examined by quantitative PCR targeting 16S rRNA and toxin genes. Toxigenic C. difficile was detected in 18 of 111 infants (16%) in the period up to the age of 6 months. The carriage rate of toxigenic C. difficile remained below 5% until the age of 3 months. The carriage rate increased to 13% 1 week after weaning (average age, 143 days) and reached 16% at the age of 6 months. Counts of toxigenic C. difficile bacteria ranged from 10 4 to 10 8 cells/g of stool. Notably, two infants retained >10 8 cells/g of stool for at least several weeks. Average counts in the 18 infants hovered around 10 7 cells/g of stool from the age of 3 days until the age of 6 months, showing no age-related trend. Genotyping of toxigenic C. difficile isolates from the 18 infants revealed that 11 infants each retained a particular monophyletic strain for at least a month. The genotype most frequently identified was the same as that frequently identified in symptomatic adult CDI patients. Thus, toxigenic C. difficile strains-potential causes of CDI in adults-colonized the infants' intestines. IMPORTANCEOur study provides longitudinal data on counts and strain types of toxigenic C. difficile in infants. We found that considerable numbers of toxigenic C. difficile bacteria colonized the infants' intestines. The results of strain typing suggest that toxigenic C. difficile carried by healthy infants could be potentially pathogenic to adults. These results and findings are informative not only for ecological studies but also for efforts to prevent or control the spread of CDI in adults. Toxigenic Clostridium difficile is the main cause of health careassociated gastrointestinal infections. In general, C. difficile is not a normal inhabitant of the adult gastrointestinal tract, because its colonization is considered to be prevented by the presence of commensal microbiota (1-3). Colonization of the intestines by toxigenic C. difficile is the first crucial step in the development of C. difficile infection (CDI). Accumulating evidence suggests that disruption of the microbiota and frequent exposure to toxigenic C. difficile could increase the risk of CDI (4-6). Whereas asymptomatic carriage of toxigenic C. difficile is rare in adults, occurring in Ͻ5% of adults (7,8), it is very common in infants (9, 10), probably due to the immaturity of the microbiota composition. Regardless of the high prevalence, a great majority of infants rarely show CDI-related abdominal symptoms. The presumed reason for this is that infants are not susceptible to C. difficile toxins owing to the poor developmen...

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“…Because the RT 078 and 126 strains are genetically similar to each other with regard to ribotyping profiles, some experts have reported them as RT 078/126 or have even not differentiated between them [26]. For example, in C. difficile surveillance in the residents of long-term care wards in France, RT 078/126 (12.1%) was the second most common ribotype, after RT 014/020/077 (18.7%) [27]. In addition to human diseases, RT 126 constitutes the most common ribotype in diarrheal animals, including piglets or calves, in Europe [28,29].…”

Section: Discussionmentioning

confidence: 99%

Clostridium difficile ribotype 126 in southern Taiwan: A cluster of three symptomatic cases

et al. 2014

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Clinical and microbiological features of Clostridium difficile infections in France: The ICD-RAISIN 2009 national survey

Cited by 58 publications

References 28 publications

Clostridium difficile bacteremia: Report of two cases in French hospitals and comprehensive review of the literature

Clostridium difficile bacteremia: Report of two cases in French hospitals and comprehensive review of the literature

Longitudinal Investigation of Carriage Rates, Counts, and Genotypes of Toxigenic Clostridium difficile in Early Infancy

Clostridium difficile ribotype 126 in southern Taiwan: A cluster of three symptomatic cases

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