High frequency of antibiotic-associated diarrhea due to toxin A-negative, toxin B-positive Clostridium difficile in a hospital in Japan and risk factors for infection

M. Komatsu, H. Kato, M. Aihara, K. Shimakawa, M. Iwasaki, Y. Nagasaka, S. Fukuda, S. Matsuo, Y. Arakawa, M. Watanabe, Y. Iwatani

研究成果: ジャーナルへの寄稿学術論文査読

64 被引用数 (Scopus)

抄録

Patients hospitalized in a hospital with a high incidence of antibiotic-associated diarrhea due to toxin A-negative, toxin B-positive (A-/B+) Clostridium difficile were retrospectively investigated to determine the clinical manifestations and risk factors for infection. Of 77 Clostridium difficile isolates obtained from 77 patients during the 1-year investigation period, 30 were A-/B+ and 47 were toxin A-positive, toxin B-positive (A+/B+). By pulsed-field gel electrophoresis analysis, 23 of the 30 A-/B+ strains were outbreak-related, suggesting nosocomial spread of a single type of bacterium, which mainly affected patients in the wards of respiratory medicine, hematology and neurology. Using regression analysis, three factors were found to be associated with infection by A-/B+ isolates: (i) exposure to antineoplastic agents (P=0.01, odds ratio [OR]=5.1), (ii) the use of nasal feeding tubes (P=0.008, OR=5.2), and (iii) assignment to a certain internal medicine ward (P=0.05, OR=3.0). Between patients with Clostridium difficile-associated diarrhea caused by A-/B+ strains and those with A+/B+ strains, no statistically significant difference was found in body temperature, serum concentration of C-reactive protein, leukocyte count in whole blood, frequency of diarrhea, or type of underlying disease. These results indicate that A-/B+ strains of Clostridium difficile can cause intestinal infection in humans and they spread nosocomially in the same manner as A+/B+ strains.

本文言語英語
ページ(範囲)525-529
ページ数5
ジャーナルEuropean Journal of Clinical Microbiology and Infectious Diseases
22
9
DOI
出版ステータス出版済み - 01-09-2003
外部発表はい

All Science Journal Classification (ASJC) codes

  • 微生物学(医療)
  • 感染症

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