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Selected Publication:
Schreiner, E.
Colonization by Clostridium difficile in long-term care facility residents in Graz, Austria
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2018. pp. 60
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- Authors Med Uni Graz:
- Advisor:
- Leitner-Meyer Eva
- Zollner-Schwetz Ines
- Altmetrics:
- Abstract:
- Background: Infection with C. difficile is a widespread cause of diarrhoea in acute care hospitals and long-term care facilities (LTCFs). Apart from the infection rates, asymptomatic carriage rates should also be monitored for two reasons: Firstly, carriers may act as a reservoir for the bacteria and thereby contribute to the transmission of the disease. Secondly, they may develop symptomatic C. difficile infection themselves. We aimed to evaluate the prevalence of colonization with C. difficile in LTCF residents in Graz, as no data is currently available concerning Austria. Secondary objectives include risk factors for colonization. Methods: The point-prevalence study was conducted in March 2018 in Graz and included residents of four LTCFs who did not show any clinical signs of an infection with C. difficile. Stool samples were tested with a glutamate-dehydrogenase-enzyme immunoassay. Positive samples were then tested with a toxin A/B-enzyme immunoassay. The samples were also cultivated on agar plates. Suspicious colonies were confirmed using MALDI-TOF. C. difficile isolates were tested for antimicrobial susceptibility. Carriers were retested after one month to see if C. difficile can still be detected. Moreover, swabs were taken from their residential units to identify a possible contamination with spores. Demographic and clinical information of the patients were collected, for instance, length of stay in the long-term care facility, level of care, diabetes, mobility, faecal and urinary incontinence or administration of antibiotics in the last 3 months. Results: Asymptomatic carriage of C. difficile was confirmed in 4 (2.78%) of the 144 collected samples. The prevalence ranged from 0 to 7.69% in the different facilities. After one month, two of three available carriers were still colonised. None of the examined strains showed resistance to metronidazole or vancomycin. The rate of diabetes mellitus differed significantly between the carriers (75%) and the non-carriers (20%, p: 0.031). The environmental swabs did not show any contamination with spores. Conclusion: The asymptomatic carriage rate in Graz is comparable to results from Germany, Switzerland and Italy (2-5.1%). According to our results, diabetes mellitus might be a possible risk factor for asymptomatic carriage of C. difficile.