Abstract:
BACKGROUND:A prospective study was performed to investigate the prevalence of colonization among ICU patients and to examine whether asymptomatic carriers were the source of subsequent C. difficile infection (CDI) and acquisition of toxigenic C. difficile. METHODS:Rectal swabs were collected from adult patients on admission to and at discharge from a 50-bed medical ICU of a major referral hospital in western China, from August to November 2014. Stools were collected from patients who developed ICU-onset diarrhea. Both swabs and stools were screened for tcdB (toxin B gene) by PCR. Samples positive to tcdB were cultured for C. difficile and isolates recovered were screened for tcdB and the binary toxin genes by PCR. Strain typing was performed using multilocus sequence typing and isolates belonging to the same sequence type (ST) were further typed using multiple-locus variable number tandem repeat analysis (MLVA). RESULTS:During the 4-month period, rectal swabs were collected from 360 (90.9 %) out of 396 patients who were admitted to the ICU. Among the 360 patients, 314 had stayed in the ICU more than 3 days, of which 213 (73.6 %) had a rectal swab collected within the 3 days prior to discharge from ICU. The prevalence of toxigenic C. difficile colonization was 1.7 % (6 cases) and 4.3 % (10 cases) on admission and discharge, respectively. Only four (1.1 %) out of 360 patients had CDI, corresponding to 10.7 cases per 10,000 ICU days. None of the four cases had toxigenic C. difficile either on admission or at discharge. Toxigenic C. difficile isolates were recovered from all swabs and stool samples positive for tcdB by PCR and belonged to 7 STs (ST2, 3, 6, 37, 54, 103 and 129). None of the isolates belonging to the same ST had identical MLVA patterns. Binary toxin genes were detected in one ST103 isolate that caused colonization. CONCLUSION:The prevalence of colonization with toxigenic C. difficile among patients on admission to ICU was low in our setting. ICU-acquired toxigenic C. difficile were not linked to those detected on admission. Active screening for toxigenic C. difficile may not be a resource-efficient measure in settings with a low prevalence of colonization.
journal_name
BMC Infect Disjournal_title
BMC infectious diseasesauthors
Zhang X,Wang X,Yang J,Liu X,Cai L,Zong Zdoi
10.1186/s12879-016-1729-2subject
Has Abstractpub_date
2016-08-09 00:00:00pages
397issn
1471-2334pii
10.1186/s12879-016-1729-2journal_volume
16pub_type
杂志文章abstract:BACKGROUND:Despite the widespread offer of free HIV testing in France, the proportion of people who have never been tested remains high. The objective of this study was to identify, in men and women separately, the various factors independently associated with no lifetime HIV testing. METHODS:We used multilevel logist...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-015-1006-9
更新日期:2015-07-22 00:00:00
abstract:BACKGROUND:Brucellosis is endemic in many areas in China. The current diagnosis of Brucellosis predominantly relies on the traditional bacterial culture and serum agglutination test. In this study, we aimed to explore the value of ELISA in the diagnosis of Brucellosis in Chinese population. METHODS:We recruited 235 pa...
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更新日期:2003-11-14 00:00:00
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pub_type: 杂志文章
doi:10.1186/1471-2334-10-265
更新日期:2010-09-10 00:00:00
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更新日期:2013-04-18 00:00:00
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更新日期:2011-02-07 00:00:00
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更新日期:2007-04-10 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2020-10-16 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2012-03-22 00:00:00
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更新日期:2015-10-13 00:00:00
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