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Updated: May 28, 2026
06:51
Cefoperazone-treated Mouse Model of Clinically-relevant Clostridium difficile Strain R20291
Published on: December 10, 2016
Host and pathogen factors for Clostridium difficile infection and colonization
Vivian G Loo1, Anne-Marie Bourgault, Louise Poirier
1Department of Microbiology, McGill University Health Centre, 687 Pine Ave. W., Rm. L5.06, Montreal, QC H3A 1A1, Canada.
The New England Journal of Medicine
|November 4, 2011
Summary
Healthcare-associated Clostridium difficile infection and colonization risk factors were identified. Older age, antibiotics, and PPIs linked to infection, while prior hospitalization and other factors linked to colonization.
Area of Science:
- Infectious Diseases
- Epidemiology
- Microbiology
Background:
- Clostridium difficile infection (CDI) is a primary cause of hospital-acquired diarrhea.
- The bacterium can also lead to asymptomatic colonization.
- Understanding factors driving CDI acquisition and colonization is crucial for prevention.
Purpose of the Study:
- To identify host and bacterial factors associated with healthcare-associated CDI and colonization.
- To differentiate risk factors for active infection versus asymptomatic carriage.
Main Methods:
- Prospective study across six Canadian hospitals over 15 months.
- Collected demographic data, risk factors, and weekly stool/swab samples.
- Utilized pulsed-field gel electrophoresis (PFGE) for strain typing and measured serum antibodies against C. difficile toxins A and B.
Main Results:
- 117 patients (2.8%) developed CDI; 123 (3.0%) became colonized.
- Older age, antibiotic use, and proton-pump inhibitors (PPIs) correlated with CDI.
- Prior hospitalization, chemotherapy, PPIs, H2 blockers, and anti-toxin B antibodies linked to colonization.
- The North American PFGE type 1 (NAP1) strain was prevalent in CDI (62.7%) and colonization (36.1%).
Conclusions:
- Host and pathogen variables differentially influence CDI and colonization.
- The NAP1 strain is predominant in C. difficile infection.
- Asymptomatic carriers are more frequently colonized by non-NAP1 strains.
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