Clostridium difficile colonization in healthy adults: transient colonization and correlation with enterococcal colonization

• Published in: Journal of medical microbiology Vol. 53; no. 2; pp. 167 - 172
• Main Authors: Ozaki, Eijiro, Kato, Haru, Kita, Hiroyuki, Karasawa, Tadahiro, Maegawa, Tsuneo, Koino, Youko, Matsumoto, Kazumasa, Takada, Toshihiko, Nomoto, Koji, Tanaka, Ryuichiro, Nakamura, Shinichi
• Format: Journal Article
• Language: English
• Published: Reading Soc General Microbiol 01.02.2004; Society for General Microbiology
• Subjects: Adult; Aged; Biological and medical sciences; Carrier State - microbiology; Clostridium difficile; Clostridium difficile - classification; Clostridium difficile - genetics; Clostridium difficile - growth & development; Clostridium difficile - isolation & purification; Electrophoresis, Gel, Pulsed-Field; Enterococcus; Enterococcus - genetics; Enterococcus - growth & development; Enterococcus - isolation & purification; Enterocolitis, Pseudomembranous - microbiology; Fundamental and applied biological sciences. Psychology; Humans; Infectious diseases; Intestines - microbiology; Medical sciences; Microbiology; Middle Aged; Polymerase Chain Reaction; Ribotyping; Human; Microbiology; Clostridiaceae; Clostridium difficile; Clostridiales; Bacteria; Adult
• ISSN: 0022-2615; 1473-5644
• DOI: 10.1099/jmm.0.05376-0

1 Department of Bacteriology, Graduate School of Medical Science, Kanazawa University, Kanazawa 920-8640, Japan 2 Yakult Central Institute for Microbiological Research, Tokyo 186-8650, Japan Correspondence Tadahiro Karasawa karasawa{at}med.kanazawa-u.ac.jp Received July 4, 2003 Accepted November 17, 2003 The aim of the present study was to investigate the colonization status of Clostridium difficile in healthy individuals. In total, 139 healthy adults from two study groups were examined at intervals of 3 months. Among the 18 positive subjects, the number of subjects from whom C. difficile was isolated once, twice, three times or four times was 10 (55.6 %), three (16.7 %), two (11.1 %) and three (16.7 %), respectively. In the student group, different subjects were colonized by different PCR ribotype/PFGE types. However, the same PCR ribotype/PFGE types of C. difficile were isolated from different subjects in the employee group, indicating that cross-transmission may have occurred in this group. Continuous colonization by the same PCR ribotype/PFGE type was only observed in three subjects. C. difficile -positive subjects were significantly more densely colonized by enterococci ( P < 0.05) than C. difficile -negative subjects: subjects that were found to be C. difficile -positive three or four times appeared to have higher concentrations of enterococci. The present results demonstrate that, although colonization by a C. difficile strain is transient in many cases, there are healthy individuals that are colonized persistently by C. difficile . They also suggest that dense colonization of the intestine by enterococci may be associated with C. difficile colonization. Present address: Department of Bacterial and Blood Products, National Institute of Infectious Diseases, Tokyo 208-0011, Japan. Abbreviation: CDAD, C. difficile -associated diarrhoea.