Maternal Transmission of Symptomatic Clostridioides difficile Infection to Two Premature Neonates

Area of Science:

• Neonatal Medicine
• Infectious Diseases
• Microbiology

Background:

• Neonatal Clostridioides difficile infections (CDI) present diagnostic challenges due to high asymptomatic colonization rates in newborns.
• Differentiating between colonization and active infection in neonates is difficult.

Purpose of the Study:

• To report a case of severe maternal CDI and subsequent transmission to triplets.
• To highlight the importance of considering neonatal CDI testing in peripartum maternal CDI cases.

Main Methods:

• Case report detailing a severe maternal CDI case with prior hospitalization and antibiotic use.
• Description of transmission of toxin-producing C. difficile (PCR ribotype 002) from mother to triplets.
• Clinical observation of neonatal outcomes and treatment response.

Main Results:

• A 48-year-old mother with severe CDI transmitted C. difficile to her three premature neonates (31 weeks gestation).
• Two of the three neonates developed diarrhea consistent with CDI.
• Both affected neonates responded well to anti-CDI treatment.

Conclusions:

• Maternal CDI during the peripartum period necessitates consideration of CDI testing in neonates.
• Early diagnosis and treatment of neonatal CDI are crucial, even with high colonization rates.