Carriage of Clostridioides difficile in healthy infants in the community of Handan, China: A 1-year follow-up study

Anaerobe. 2021 Feb:67:102295. doi: 10.1016/j.anaerobe.2020.102295. Epub 2020 Nov 24.

Abstract

Objective: Clostridioides difficile may colonize healthy infants and young children asymptomatically and for the long-term. C. difficile genotypes and the rate and determinants of colonization differ substantially and vary among countries and regions. A 1-year follow-up study was performed to determine the incidence, kinetics and influencing factors of C. difficile intestinal colonization.

Methods: Twenty-nine healthy infants (14 girls and 15 boys) living at home with their parents in Handan City were followed by survey from birth to 1 year of age, specifically from October 2014 through December 2015. C. difficile isolates were typed by PCR ribotyping and analyzed for the presence of toxin genes.

Results: During the follow-up study period in the first year of life, 20 of the 29 total enrolled infants acquired C. difficile. A total of 437 fecal samples were obtained, and 111 (25.4%) samples contained C. difficile, including 79 (71.2%) toxigenic strains. The toxigenic isolates comprised six PCR ribotypes, and two PCR ribotypes were identified as nontoxigenic strains.

Conclusion: Our study showed that C. difficile colonization increase with age during the 12-month period, and the dominant toxigenic types of C. difficile isolates in infants were those involved in long-term colonization. Feeding patterns may affect the dynamic progress of C. difficile colonization.

Keywords: Clostridioides difficile; Colonization; Community; Dynamic progress; Follow-up study; Infants.

MeSH terms

  • Biodiversity
  • Carrier State / epidemiology*
  • China / epidemiology
  • Clostridioides difficile / classification*
  • Clostridioides difficile / genetics*
  • Clostridioides difficile / isolation & purification
  • Clostridium Infections / epidemiology*
  • DNA, Bacterial
  • Feces / microbiology
  • Feeding Behavior
  • Female
  • Follow-Up Studies
  • Genotype
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Intestines / microbiology
  • Male
  • Polymerase Chain Reaction
  • RNA, Ribosomal, 16S
  • Ribotyping

Substances

  • DNA, Bacterial
  • RNA, Ribosomal, 16S