High prevalence of nontoxigenic Clostridium difficile isolated from hospitalized and non-hospitalized individuals in rural Ghana.
Since data about Clostridium difficile infection in sub-Saharan Africa are scarce, we determined its epidemiology and risk factors in a cross-sectional study in Eikwe, a rural community in Ghana. We tested stool samples from 176 hospitalized patients with diarrhoea and from 131 asymptomatic non-hospitalized individuals for C. difficile and some other enteric pathogens. The overall prevalence rate of C. difficile was 4.9% with ribotype 084 being predominant. With 75% of the isolates, a high rate of nontoxigenic strains was present in symptomatic patients, most of whom had no other identified enteric pathogens. All strains were susceptible against metronidazole and vancomycin, respectively. Data on lifestyle and medical history showed that age <5years (p=0.004), and use of ceftriaxone (p=0.023) were the most important risk factors for C. difficile carriage status. Although our data suggest that C. difficile is currently not a major cause of diarrhoea in this setting, the epidemiology of C. difficile in sub-Saharan Africa awaits further investigation.
University Medical Center Göttingen, Institute of Medical Microbiology, Kreuzbergring 57, D37075 Göttingen, Germany.
Iryna
I
Janssen
St. Martin de Porres Hospital, Eikwe, W/R, Ghana.
Paul
P
Cooper
University Medical Center Göttingen, Institute of Medical Microbiology, Kreuzbergring 57, D37075 Göttingen, Germany.
Katrin
K
Gunka
University of Maribor, Faculty of Medicine, Taborska 8, SVN2000 Maribor, Slovenia; National Laboratory for Health, Environment and Food (NLZOH), Prvomajska 1, SVN 2000 Maribor, Slovenia.
Maja
M
Rupnik
University Medical Center Göttingen, Institute of Medical Microbiology, Kreuzbergring 57, D37075 Göttingen, Germany.
Daniela
D
Wetzel
University Medical Center Göttingen, Institute of Medical Microbiology, Kreuzbergring 57, D37075 Göttingen, Germany.
Ortrud
O
Zimmermann
University Medical Center Göttingen, Institute of Medical Microbiology, Kreuzbergring 57, D37075 Göttingen, Germany; Göttingen International Health Network, Göttingen, Germany. Electronic address: ugross@gwdg.de.
Uwe
U
Groß
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001427:Bacterial Toxins / Q000235:genetics / Q000378:metabolism*; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology; D002443:Ceftriaxone / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D016360:Clostridioides difficile / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000453:epidemiology* / Q000382:microbiology*; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology; D005243:Feces / Q000382:microbiology; D005260:Female; D005869:Ghana; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008795:Metronidazole / Q000494:pharmacology; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D021521:Ribotyping; D012307:Risk Factors; D012424:Rural Population; D014640:Vancomycin / Q000494:pharmacology; D055815:Young Adult
D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D008795:Metronidazole; D014640:Vancomycin; D002443:Ceftriaxone
Africa; Clostridium difficile; Epidemiology; Nontoxigenic strain