title: Colonisation and transmission of Clostridium difficile in healthy individuals examined by PCR ribotyping and pulsed-field gel electrophoresis.
abstract: Healthy adults who had not been exposed to antimicrobial agents for the preceding 4 weeks were examined for intestinal carriage of Clostridium difficile. The 1234 individuals examined were composed of seven groups: three classes of university students, hospital workers at two hospitals, employees of a company and self-defence force personnel at a local station. Overall, 94 (7.6%) individuals were positive for C. difficile by faecal culture but carriage rates among the study groups ranged from 4.2% to 15.3%. Typing by PCR ribotyping and pulsed-field gel electrophoresis demonstrated clusters of carriers colonised by a single type in each of three groups, indicating that cross-transmission of C. difficile can occur in community settings. Follow-up culture was performed on 38 C. difficile-positive individuals and C. difficile was isolated again from 12 (32%) of them 5-7 months after the initial culture; six (50%) of these 12 individuals had a new strain on repeat culture. Two or more family members were C. difficile-positive in five of 22 families examined. C. difficile with an identical type was isolated from persons within a family in only one family. These results suggest that intestinal carriage by healthy adults may play a role as a reservoir for community-acquired C. difficile-associated diarrhoea, but that cross-transmission of C. difficile does not occur frequently among family members at home.
authors.forename: H
authors.initials: H
authors.lastname: Kato
authors.forename: H
authors.initials: H
authors.lastname: Kita
authors.forename: T
authors.initials: T
authors.lastname: Karasawa
authors.forename: T
authors.initials: T
authors.lastname: Maegawa
authors.forename: Y
authors.initials: Y
authors.lastname: Koino
authors.affiliation: Department of Bacteriology, *First Department of Internal Medicine, School of Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8640, †General Service Corps, Kanazawa Station, Ground Self Defence Force, 1-8 Noda-machi, Kanazawa 921-8520 and ‡Department of Laboratory Science, School of Health Science, School of Medicine, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa 920-0942, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Takakuwa
authors.affiliation: Department of Bacteriology, *First Department of Internal Medicine, School of Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8640, †General Service Corps, Kanazawa Station, Ground Self Defence Force, 1-8 Noda-machi, Kanazawa 921-8520 and ‡Department of Laboratory Science, School of Health Science, School of Medicine, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa 920-0942, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Saikai
authors.affiliation: Department of Bacteriology, *First Department of Internal Medicine, School of Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8640, †General Service Corps, Kanazawa Station, Ground Self Defence Force, 1-8 Noda-machi, Kanazawa 921-8520 and ‡Department of Laboratory Science, School of Health Science, School of Medicine, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa 920-0942, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kobayashi
authors.affiliation: Department of Bacteriology, *First Department of Internal Medicine, School of Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8640, †General Service Corps, Kanazawa Station, Ground Self Defence Force, 1-8 Noda-machi, Kanazawa 921-8520 and ‡Department of Laboratory Science, School of Health Science, School of Medicine, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa 920-0942, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yamagishi
authors.forename: S
authors.initials: S
authors.lastname: Nakamura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002353:Carrier State / Q000382:microbiology / Q000635:transmission*; D016360:Clostridioides difficile / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D017714:Community-Acquired Infections / Q000382:microbiology / Q000635:transmission; D004197:Disease Reservoirs; D016521:Electrophoresis, Gel, Pulsed-Field / Q000379:methods; D004761:Enterocolitis, Pseudomembranous / Q000382:microbiology / Q000635:transmission*; D005190:Family; D005243:Feces / Q000382:microbiology*; D005260:Female; D020459:Genes, rRNA / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D021521:Ribotyping