title: Clostridium difficile colonization in preoperative colorectal cancer patients.
abstract: The entire process of Clostridium difficile colonization to infection develops in large intestine. However, the real colonization pattern of C. difficile in preoperative colorectal cancer patients has not been studied. In this study, 33 C. difficile strains (16.1%) were isolated from stool samples of 205 preoperative colorectal cancer patients. C. difficile colonization rates in lymph node metastasis patients (22.3%) were significantly higher than lymph node negative patients (10.8%) (OR=2.314, 95%CI=1.023-5.235, P =0.025). Meanwhile, patients positive for stool occult blood had lower C. difficile colonization rates than negative patients (11.5% vs. 24.0%, OR=0.300, 95%CI=0.131-0.685, P =0.019). A total of 16 sequence types were revealed by multilocus sequence typing. Minimum spanning tree and time-space cluster analysis indicated that all C. difficile isolates were epidemiologically unrelated. Antibiotic susceptibility testing showed all isolates were susceptible to vancomycin and metronidazole. The results suggested that the prevalence of C. difficile colonization is high in preoperative colorectal cancer patients, and the colonization is not acquired in the hospital. Since lymph node metastasis colorectal cancer patients inevitably require adjuvant chemotherapy and C. difficile infection may halt the ongoing treatment, the call for sustained monitoring of C. difficile in those patients is apparently urgent.
authors.affiliation: Cancer Biotherapy Center, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: Department of Microbiology, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Luo
authors.affiliation: Xinchang People's Hospital, Shaoxing, China.
authors.forename: Yinxiang
authors.initials: Y
authors.lastname: Lv
authors.affiliation: Department of Microbiology, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Huang
authors.affiliation: Department of Colorectal Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Qinsong
authors.initials: Q
authors.lastname: Sheng
authors.affiliation: Cancer Biotherapy Center, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Zhao
authors.affiliation: Department of Microbiology, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Julian
authors.initials: J
authors.lastname: Ye
authors.affiliation: Cancer Biotherapy Center, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Weiqin
authors.initials: W
authors.lastname: Jiang
authors.affiliation: Cancer Biotherapy Center, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Lulu
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Microbiology, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Song
authors.affiliation: Cancer Biotherapy Center, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Zhou
authors.initials: Z
authors.lastname: Tong
authors.affiliation: Department of Colorectal Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Wenbin
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Colorectal Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Jianjiang
authors.initials: J
authors.lastname: Lin
authors.affiliation: Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center; Department of Pathology and Medicine, Weill Medical College of Cornell University, New York, NY, USA.
authors.forename: Yi-Wei
authors.initials: YW
authors.lastname: Tang
authors.affiliation: Department of Microbiology, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Dazhi
authors.initials: D
authors.lastname: Jin
authors.affiliation: Cancer Biotherapy Center, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Weijia
authors.initials: W
authors.lastname: Fang
mesh_terms: D016360:Clostridioides difficile / Q000302:isolation & purification*; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology; D004761:Enterocolitis, Pseudomembranous / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period
keywords: Clostridium difficile; colonization; colorectal cancer; epidemiology; transmission