Monitoring of Clostridium difficile colonization in preterm infants in neonatal intensive care units

Ju Young Chang, Jung Ok Shim, Jae Sung Ko, Jeong Kee Seo, Jin A. Lee, Han Suk Kim, Jung Hwan Choi, Sue Shin, Son Moon Shin

    Research output: Contribution to journalArticlepeer-review

    4 Citations (Scopus)

    Abstract

    Purpose: To examine the prevalence of Clostridium difficile (C. difficile) colonization (CDC) and potential neonatal determinants of CDC in hospitalized preterm infants. Methods: Fecal samples were serially collected within 72 h after birth and at 1, 2, and 4-6 weeks of age from preterm infants in the neonatal intensive care units (NICUs) of two different university hospitals. Total bacterial DNA was extracted from each fecal sample from 49 infants, and polymerase chain reaction (PCR) was performed with primers for the 16S gene of C. difficile and the toxin A and toxin B genes. The correlation between the results of C. difficile PCR assays and the clinical characteristics of the infants was analyzed. Results: The prevalence rates of CDC were 34.7, 37.2, 41.3, and 53.1% within 72 h after birth and at 1, 2, and 4-6 weeks of age, respectively. The toxin positivity rate was significantly higher in the infants with persistent CDC than in those with transient CDC (8/12 [66.7%] vs. 6/25 [24.5%] (p=0.001). Among the various neonatal factors, only the feeding method during the first week after birth was significantly associated with persistent CDC. Exclusive breast-milk feeding (EBMF) significantly decreased the risk of persistent CDC compared to formula or mixed feeding (adjusted odds ratio: 0.133, 95% confidence interval: 0.02-0.898, p=0.038). Conclusion: The prevalence of CDC increased with the duration of hospitalization in preterm infants in the NICU. EBMF during the first week after birth in hospitalized preterm infants may protect against persistent CDC.

    Original languageEnglish
    Pages (from-to)29-37
    Number of pages9
    JournalPediatric Gastroenterology, Hepatology and Nutrition
    Volume15
    Issue number1
    DOIs
    Publication statusPublished - 2012

    Keywords

    • Breast-milk feeding
    • Clostridium difficile
    • NICU
    • Preterm infants

    ASJC Scopus subject areas

    • Pediatrics, Perinatology, and Child Health
    • Hepatology
    • Gastroenterology

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