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Prevalence and diversity of Clostridium difficile strains in infants

Clotilde Rousseau1,2, Ludovic Lemée3,4, Alban Le Monnier5,2

  • 1Service de Microbiologie, Hôpital Jean Verdier, Assistance Publique - Hôpitaux de Paris, Bondy, France.

Journal of Medical Microbiology
|March 12, 2011
PubMed

Insights

Infants frequently carry Clostridium difficile, with 33.7% colonized. Toxigenic strains, including adult infectious types, were found in 7.1% of infants, suggesting they may act as reservoirs for C. difficile transmission.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pediatrics

Background:

  • Asymptomatic intestinal colonization by Clostridium difficile is common in early infancy.
  • Understanding infant colonization prevalence and strain characteristics is crucial for public health.

Purpose of the Study:

  • To determine the prevalence of Clostridium difficile colonization in infants aged 0-2 years.
  • To characterize infant C. difficile strains by virulence factors and phylogenetic diversity.
  • To assess the potential role of infants as reservoirs for adult C. difficile strains.

Main Methods:

  • Prospective screening of C. difficile in infant stools using toxigenic culture.
  • Molecular characterization via PCR-ribotyping (PRs) and multilocus sequence typing (MLST).

Main Results:

  • Overall C. difficile colonization prevalence was 33.7%, with 7.1% carrying toxigenic strains.
  • Community-acquired C. difficile accounted for 66.7% of cases.
  • Seventeen PCR ribotypes and 15 sequence types were identified; PRJV11-ST38 (non-toxigenic) was predominant.
  • Toxigenic strains, including some resembling adult infectious strains, were identified in asymptomatic infants.

Conclusions:

  • Infants are widely colonized by C. difficile, predominantly non-toxigenic strains.
  • Toxigenic C. difficile strains, including those known to cause severe infections in adults, circulate in asymptomatic infants.
  • Infants may serve as a reservoir for the community spread of adult C. difficile infectious strains.

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