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Clostridium difficile: epidemiology and clinical features

T J Marrie, M Furlong, R S Faulkner

    Canadian Journal of Surgery. Journal Canadien De Chirurgie
    |July 1, 1982
    PubMed
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    Clostridium difficile infections were studied in Halifax, Nova Scotia. The bacteria were found in hospitalized patients, with evidence of clustering and higher toxin production linked to antibiotic use.

    Area of Science:

    • Infectious Diseases
    • Epidemiology
    • Gastroenterology

    Background:

    • Clostridium difficile is a significant cause of infectious diarrhea in healthcare settings.
    • Understanding its epidemiology is crucial for infection control and prevention strategies.

    Purpose of the Study:

    • To investigate the prevalence and characteristics of Clostridium difficile (C. difficile) in hospitalized patients and other groups in Halifax, Nova Scotia.
    • To identify risk factors and clinical presentations associated with C. difficile infection.

    Main Methods:

    • A study involving four groups: hospitalized patients with diarrhea, hospitalized patients on general medical wards, outpatients with gastrointestinal disorders, and healthy subjects.
    • Stool sample analysis for C. difficile and its cytotoxin.

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  • Sigmoidoscopic examinations to assess colonic mucosa.
  • In vitro toxin production assays.

    • Main Results:

    • C. difficile was detected in patients with diarrhea, hospitalized patients on general wards (17% carriage), and a small proportion of outpatients (4.5%).
    • Pseudomembranous colitis was observed in 6 of 18 patients with abnormal colonic mucosa and 3 of 13 patients with C. difficile on general wards.
    • Clustering of C. difficile cases was noted among hospitalized patients.
    • In vitro toxin production was more frequent in C. difficile isolates from patients who had received antibiotics.

    Conclusions:

    • Clostridium difficile is present in various patient populations in Halifax, with a notable prevalence in hospitalized individuals.
    • Antibiotic use appears to be associated with increased in vitro toxin production.
    • The clinical spectrum ranges from asymptomatic carriage to severe pseudomembranous colitis.