1986
DOI: 10.1136/jcp.39.8.861
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Isolation of Clostridium difficile from human jejunum: identification of a reservoir for disease?

Abstract: SUMMARY The possibility that the small intestine may represent a reservoir for Clostridium difficile was studied, using segments of human jejunum collected at necropsy. Our results (three of 100 specimens positive for C difficile culture) support the hypothesis that C difficile can be found in human jejunum and that it adheres to the normal mucosa as a resident bacterium. These findings suggest that gastrointestinal disease caused by C difficile has an endogenous origin.The possibility that the small intestine… Show more

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Cited by 50 publications
(31 citation statements)
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“…9 The jejunum appears to be a reservoir of the organism in selected patients, but small bowel involvement has been considered to be quite uncommon. 10,11 In recent years, a small number of reports of C. difficile enteritis have been published. In most cases, the small bowel involvement has occurred in patients with fulminant C. difficile colitis.…”
Section: Discussionmentioning
confidence: 99%
“…9 The jejunum appears to be a reservoir of the organism in selected patients, but small bowel involvement has been considered to be quite uncommon. 10,11 In recent years, a small number of reports of C. difficile enteritis have been published. In most cases, the small bowel involvement has occurred in patients with fulminant C. difficile colitis.…”
Section: Discussionmentioning
confidence: 99%
“…10 Workers subsequently demonstrated that among patients who died from nongastrointestinal causes, 3 percent of their healthy jejunal specimens yielded positive C. difficile cultures. 13 They suggested that C. difficile carriers may be colonized throughout the whole gastrointestinal tract, where it adheres to the normal mucosa as a resident bacterium. Lamont and Trnka 7 described a 23-year-old female who had a previous subtotal colectomy with mucus fistula and ileostomy formation.…”
Section: Discussionmentioning
confidence: 99%
“…Their interesting finding was the synergistic effect of toxin In humans, most cases of C. difficile infection have been associated only with colon; however, the organism has been isolated from the jejunal segments in autopsy (3/100 patients) and from the jejunal aspirate of patients with chronic diarrhea, raising the possibility that the small intestine may serve as a reservoir for recolonizing large intestine. 8,9 Furthermore, the epithelium of pelvic ileal pouches after a total colectomy has the capacity to undergo morphologic changes that may facilitate fecal flora establishment. These include mild villus atrophy, Paneth_s cell hyperplasia, and a partial transition to colonic mucin phenotype without complete metaplasia.…”
Section: Discussionmentioning
confidence: 99%