Document Type
Journal Article
Publication Title
Journal of Hospital Infection
Publisher
Elsevier
School
School of Medical and Health Sciences
RAS ID
35455
Funders
Conquer Cystic Fibrosis Charlies Foundation for Research Vertex Adult Cystic Fibrosis Fellowship, Thoracic Society of Australia and New Zealand
Abstract
Background Little is known about Clostridioides difficile infection (CDI) in patients with cystic fibrosis (CF). The aim of this study was to investigate the prevalence, molecular epidemiology and risk factors for CDI in asymptomatic and symptomatic adults with CF in Western Australia. Methods Faecal samples from symptomatic and asymptomatic patients were prospectively collected and tested for the presence of C. difficile by toxigenic culture. Ribotyping was performed by established protocols. Logistic regression analysis was performed to analyse the risk factors for C. difficile colonization and infection. Extensive environmental sampling was performed within the CF clinic in Perth. Results The prevalence rates of asymptomatic toxigenic and non-toxigenic C. difficile colonization were 30% (14/46 patients) and 24% (11/46 patients), respectively. Fifteen ribotypes (RTs) of C. difficile were identified, of which non-toxigenic RT 039 was the most common. Among the symptomatic patients, the prevalence of toxigenic CDI was 33% (11/33 patients). Impaired glucose tolerance/diabetes mellitus and duration of intravenous antibiotic use in the past 12 months were significantly associated with increased risk of asymptomatic toxigenic C. difficile carriage and CDI. A trend towards higher CF transmembrane conductance regulator modulator treatment was observed in the CDI group. Extensive environmental sampling showed no evidence of toxigenic C. difficile contamination within the CF clinic. Conclusions A high prevalence of asymptomatic carriage of toxigenic C. difficile was observed in adults with CF, comparable with that observed in the symptomatic CF population. There was no evidence of direct person-to-person transmission.
DOI
10.1016/j.jhin.2021.03.018
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Comments
This is an author's accepted manuscript of: Tai, A. S., Putsathit, P., Eng, L., Imwattana, K., Collins, D. A., Mulrennan, S., & Riley, T. V. (2021). Clostridioides difficile colonisation and infection in a cohort of Australian adults with cystic fibrosis. Journal of Hospital Infection, 113, 44-51. https://doi.org/10.1016/j.jhin.2021.03.018