[Incidence and origin of Clostridium difficile in neonatology]

The epidemiology of Clostridium difficile was studied prospectively in 101 newborn infants by screening of fecal samples collected in the first or second day of life and in the fourth or fifth one. A vaginal swab and a stool specimen were collected from mothers before delivery. Environmental cultures were obtained from selected sites in the ward, while colonization of intestinal tract and contamination of the hands were evaluated in the personnel. C. difficile was isolated from the feces of 13 infants (13%); colonization rate was higher in infants delivered by cesarean section, but the difference was not significant. Intestinal carriage was demonstrated in two mothers (2%); the baby of one colonized mother was positive for C. difficile. All vaginal swabs were negative. Fecal samples of 2 nurses (18%) were positive; none of the environmental cultures yielded C. difficile. It was concluded that the mothers are not the sources of their infants' organisms and that the contamination of the environmental surfaces is the most likely explanation for the spread of C. difficile in the hospital setting.