Characteristics and Demographic Distributions of Toxigenic Clostridium difficile Strains in Rajavithi Hospital, 2009-2015.
BACKGROUND
In recent years, toxigenic Clostridium difficile infection (CDI) has been the cause of C. difficile-associated diseases (CDAD), resulting in increasing hospitalization, community infection outbreak and mortality all over the world.


OBJECTIVE
To investigate the prevalence of toxigenic C. difficile strains in Rajavithi Hospital.


METHODS
This was a retrospective study of data from C. difficile toxin tests at Rajavithi Hospital's microbiology laboratory from January 1, 2009 to June 30, 2015.


RESULTS
Of the 5,821 stool specimens tested for C. difficile toxin, 561 (9.6%) were positive for toxigenic C. difficile strains (10.2%, 7.6%, 5.6%, 9.6%, 9.7%, 15.4% and 12.0% respectively from year 2009 to 2015). The samples of all 453 unrepeated patients with this toxigenic C. difficile strain were analyzed. Two hundred and fifty-six (56.5%) of the patients were female, and the highest prevalence (58.3%) of toxigenic C. difficile strains was found in those aged over 65 years old. Overall, 7.7% of toxigenic C. difficile strains were isolated from OPD while the other 92.3% were from IPD. The majority of these strains (73.0%) were isolated in patients from the internal medicine wards, followed by surgery wards, intensive care units (ICUs), gynecology wards, radiation oncology wards and orthopedic wards at 8.9%, 6.2%, 2.4%, 2.2% and 1.1%, respectively.


CONCLUSIONS
The prevalence of toxigenic C. difficile strains at Rajavithi Hospital was not high. The occurrence of these strains, recorded for each month of the study period, showed an irregular trend, but by far the highest frequency was found in older age groups. Rapid and accurate detection is necessary to enable immediate treatment and to stop the spread of infection. In future, these strains will be studied at a molecular level and antimicrobial susceptibility testing will be performed and the results entered in a database of toxigenic C. difficile strains in Thailand.
Prakaithip
P
Thongkoom
Suwattana
S
Kanchanahareutai
Suriwan
S
Chantrakooptungkul
Somsak
S
Rahule
D016360:Clostridioides difficile / Q000302:isolation & purification* / Q000472:pathogenicity; D004196:Disease Outbreaks; D005260:Female; D006760:Hospitalization; D006761:Hospitals; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D013997:Time Factors