title: A prospective study of community-associated Clostridium difficile infection in Kuwait: Epidemiology and ribotypes.
abstract: Clostridium difficile infection (CDI) is increasingly recognized as a significant community acquired pathogen that causes disease in the community. The aim of the study was to investigate prospectively the incidence of community-acquired-CDI (CA-CDI) in Kuwait. Of the 2584 patients with diarrhea, 16 (0.62%) were confirmed cases of CA-CDI. The other notable pathogens were Salmonella spp. (0.39%) and Campylobacter spp. (0.23%). The mean age was 39 years and the CDI was mild. Exposure to antibiotics in the previous 12 weeks, contact with infant aged <2 years and history of foreign travel was significantly associated with CA-CDI (P < 0.001; P < 0.0001; P < 0.002, respectively). Detected PCR ribotypes were 139 (n = 4) and 014, 056, 070, 097 and 179 (each n = 2). CA-CDI in Kuwait is more likely to occur in younger age and associated with ribotype 139. CA-CDI is not a common problem in Kuwait however extra vigilance must be maintained to detect it in the community even without traditional predisposing factors.
authors.affiliation: Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait; Microbiology Unit, Mubarak Al Kabir Hospital, Jabriya, Kuwait. Electronic address: wjamal@hsc.edu.kw.
authors.forename: Wafaa
authors.initials: W
authors.lastname: Jamal
authors.affiliation: Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait.
authors.forename: Eunice
authors.initials: E
authors.lastname: Pauline
authors.affiliation: Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait; Microbiology Unit, Mubarak Al Kabir Hospital, Jabriya, Kuwait. Electronic address: Vincent@hsc.edu.kw.
authors.forename: Vincent
authors.initials: V
authors.lastname: Rotimi
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D016360:Clostridioides difficile / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000453:epidemiology* / Q000382:microbiology; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology; D003967:Diarrhea / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D015994:Incidence; D007730:Kuwait / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D011446:Prospective Studies; D021521:Ribotyping; D012307:Risk Factors; D055815:Young Adult
keywords: Clostridium difficile infection; Community-acquired; Epidemiology; Kuwait; Ribotypes