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Clostridium difficile mixed infection and reinfection

David W Eyre1, A Sarah Walker, David Griffiths

  • 1NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, United Kingdom. david.eyre@ndm.ox.ac.uk

Journal of Clinical Microbiology
|November 15, 2011
PubMed

Insights

Clostridium difficile infection (CDI) can involve reinfection with different genotypes, especially when sample collection times are prolonged. This highlights the complexity of CDI and the need for accurate strain identification.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Genetics

Background:

  • Clostridium difficile infection (CDI) is a significant healthcare-associated infection.
  • Understanding the dynamics of CDI, including reinfection and mixed infections, is crucial for effective treatment and prevention.

Purpose of the Study:

  • To investigate the frequency and timing of potential reinfections with different Clostridium difficile genotypes.
  • To differentiate between true reinfection and mixed infections within a single episode.

Main Methods:

  • Multilocus sequence typing (MLST) was performed on fecal samples from consecutive Clostridium difficile infection (CDI) cases.
  • Sample pairs were analyzed to identify distinct genotypes over time.

Main Results:

  • 16% of sample pairs collected over extended periods showed evidence of potential reinfection with different genotypes.
  • The odds of reinfection increased significantly with longer intervals between sample collections.
  • A small percentage (3%) of same-day samples exhibited different genotypes, suggesting potential mixed infections.

Conclusions:

  • Distinct Clostridium difficile genotypes can cause sequential infections, indicating true reinfection rather than prolonged shedding.
  • The time interval between infections is a critical factor in distinguishing reinfection from mixed infections.
  • Accurate genotypic analysis is essential for understanding CDI epidemiology and patient management.

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