Monitoring for Clostridioides difficile-associated infection in hospital

Introduction. Clostridioides difficile — an anaerobic, spore-forming, Gram-positive bacteria — is a component of the normal intestinal microflora. C. difficile-associated infection develops during its overcolonisation, when vegetative forms produce exotoxins that cause inflammation n the colon wall. Toxigenic strains of C. difficile are the main cause of healthcare-associated infections in hospitals. The aim of the study is to investigate the frequency of detecting C. difficile (both toxigenic and non-toxigenic strains) in patients admitted to the gastroenterology department of the Yu.M. Lopukhin Federal Scientific Clinical Center for Physical and Chemical Medicine of the Federal Medical Biological Agency of Russia in 2021–2023 with diarrhea syndrome and other established diagnoses. Materials and methods. The study included 547 patients aged 19–88 years (46.6% male, 53.4% female). Real-time polymerase chain reaction was used to detect C. difficile DNA and its toxin A and B genes, and a bacteriological examination of stool was also performed. Upon detection of clinical signs of bacterial infection, a C-reactive protein (CRP) test was performed. Results. C. difficile DNA was detected in 65 (11.9%) patients, and toxins A and B genes were found in 32 (5.9%) patients. Non-toxigenic strains were more frequently detected in men (55%) under 40 years, while toxigenic strains were equally frequent in both sexes under 40. CRP analysis indicated that inflammatory processes were more likely in patients over 40 years old. The predominant diagnosis in toxigenic strain carriers with high CRP was C. difficile-associated enterocolitis (ICD-10: A04.7), whereas in the non-toxigenic group, it was ulcerative colitis (ICD-10: K51). Extended bacteriological analysis revealed significant gut microbiota imbalances in all patients. Conclusion. Over the three-year surveillance period, the prevalence of C. difficile-positive patients increased from 6.6 to 7.9%, and the proportion of samples positive for toxin A/B genes rose from 5.2% to 7.9%. These findings underscore the necessity for enhanced preventive measures to mitigate risk factors for CDI in hospital settings. Therefore, preventive measures are necessary to reduce the impact of risk factors for the development of C. difficile-associated infection in hospitals.

• Publication year

  2025

• Venue

  Journal of microbiology, epidemiology and immunobiology

• Publication date

  2025-10-31

• Fields of study

  Not labeled

• Identifiers
  DOI 10.36233/0372-9311-662
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar

• No claims are published for this paper.

• No concepts are published for this paper.

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