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Epidemiological Features of Clostridium difficile Colonizing the Intestine of Jordanian Infants

Eman N Abu-Khader1, Eman F Badran2, Asem A Shehabi1

  • 1Department of Pathology-Microbiology and Forensic Medicine, The University of Jordan, School of Medicine, Amman, Jordan.

International Journal of Microbiology
|February 10, 2018
PubMed

Insights

Clostridium difficile colonization in Jordanian infants was 12.9%, with toxigenic strains prevalent. Breastfeeding reduced colonization, while resistance to ciprofloxacin was high.

Area of Science:

  • Microbiology
  • Epidemiology
  • Pediatrics

Background:

  • Clostridium difficile is a common gut bacterium in infants.
  • Understanding C. difficile epidemiology in infants is crucial, especially in developing countries.

Purpose of the Study:

  • To investigate the epidemiological characteristics of C. difficile strains colonizing the intestines of Jordanian infants.
  • To determine colonization rates, identify toxigenic potential, and assess antibiotic resistance patterns.

Main Methods:

  • Collected 287 fecal samples from infants at Jordan University Hospital in 2015.
  • Utilized microbiological culture and PCR for C. difficile identification.
  • Assessed toxin production (TcdA, TcdB, binary toxin) and antibiotic susceptibility.

Main Results:

  • Overall C. difficile colonization rate was 12.9% (37/287).
  • Neonates had lower colonization (8.7%) than older infants (19.5%).
  • 54% of isolates were toxigenic (TcdA/TcdB), 46% nontoxigenic.
  • High resistance to ciprofloxacin (78.4%) and erythromycin (29.7%) observed.
  • 40.5% carried mutated gyrA/gyrB genes, conferring cross-resistance to fluoroquinolones.

Conclusions:

  • Breastfeeding is associated with decreased C. difficile colonization.
  • Significant antibiotic resistance, particularly to ciprofloxacin, was found in infant C. difficile isolates.
  • This study provides valuable epidemiological data on C. difficile in infants from a developing country.

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