Prevalence and toxigenicity of Clostridium difficile isolates in fecal microflora of preterm infants in the intensive care nursery.
Fecal isolates of Clostridium difficile and its toxin B were followed prospectively in 50 preterm intensive care nursery (ICN) patients. The first stool specimen was obtained after 1 week of enteral feeding, at 15 +/- 1 days of life, and 2 more specimens were collected at 2-week intervals, 24 +/- 1 and 32 +/- 2 days of life. The stools were cultured for C. difficile, and tested for C. difficile toxin B. In the first specimen 15% of stools grew C. difficile. In the second specimen C. difficile isolation rates increased to 33% and plateaued. Toxin B was detected in 71, 93 and 100% of culture-positive stools in the first, second, and third specimens, respectively. C. difficile colonization was not associated with a higher incidence of necrotizing enterocolitis or diarrhea, and using precollected, frozen human milk did not protect from C. difficile colonization.
George Washington University Hospital, Newborn Service, Washington, D.C. 20037.
A E
AE
el-Mohandes
J F
JF
Keiser
M
M
Refat
B J
BJ
Jackson
D001426:Bacterial Proteins; D001427:Bacterial Toxins / Q000302:isolation & purification; D001942:Breast Feeding; D016360:Clostridioides difficile / Q000302:isolation & purification* / Q000472:pathogenicity; D003968:Diarrhea, Infantile / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D004761:Enterocolitis, Pseudomembranous / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D005243:Feces / Q000382:microbiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000382:microbiology*; D007363:Intensive Care Units, Neonatal; D008297:Male; D015995:Prevalence
D001426:Bacterial Proteins; D001427:Bacterial Toxins; C031815:toxB protein, Clostridium difficile