One-day prevalence of asymptomatic carriage of toxigenic and non-toxigenic Clostridioides difficile in 10 French hospitals

Monnier, A. Le; Candela, Thomas; Mizrahi, Assaf; Bille, Emmanuelle; Bourgeois-Nicolaos, Nadège; Cattoir, Vincent; Farfour, Éric; Grall, I.; Lecointe, Didier; Limelette, Anne; Marcadé, G.; Poîlane, I.; Poupy, Patricia; Kansau, Imad; Zahar, Jean‐Ralph; Pilmis, Benoît; Hartmann, Clement; Kazhalawi, Alaa; Lambert-Bordes, Sylvie; Bleunven, Sophie; Réanimation, Jean-Pierre Bedos; Greder-Belan, A.; Rigaudeau, Sophie; Lécuyer, Hervé; Jousset, Agnès B; Lebeaux, David; Levy, Bénédicte; Rabaté, Clémentine; Collignon, Anne; Batah, Jameel; François, Véronique; Sebbane, Georges; Woerther, Paul‐Louis; Loggia, Gilles; Michon, J.; Verdon, Renaud; Samba, D.; Méar, Jean-Baptiste; Guillard, Thomas; Nguyen, yohan; Bani-Sadr, F.; Delmer, Alain; Himberlin, Chantal; Diallo, S.; Furet, Isabelle; Achouri, Benaissa; Reksa, Annie; Jouveshomme, Stéphane; Menage, Elodie; Philippart, François; Hadj-Abdeslam, Mohamed; Durand-Gasselin, B.; Eveillard, Matthieu; Kouatchet, Achille; Tanguy‐Schmidt, Aline; Salanoubat, Célia; Heurtaux, Marie-Noelle; Cronier, Pierrick; Foufa, Adnan

doi:10.1016/j.jhin.2022.05.011

Cited by 7 publications

(8 citation statements)

References 46 publications

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“…The question arises of the involvement of this toxin, and the implication of other virulent factors, in this type of fatal case. As for Clostridioides difficile , asymptomatic carriers of toxigenic BEC C. perfringens isolates could be possible, as the pediatric case described by Kiu et al, and asymptomatic patients may constitute a potential reservoir, highlighting the clinical importance of surveillance and monitoring of BEC-producing C. perfringens isolates in the context of public health [ 27 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

Binary Enterotoxin Producing Clostridium perfringens Isolated in Blood Cultures: Case Report and Review of the Literature

Ben Saïd,

Diancourt,

Rabeau

et al. 2024

Microorganisms

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Clostridium perfringens (C. perfringens) is an anaerobic, spore-forming Gram-positive rod responsible for necrotizing gangrene, bacteremia in patients with cancer or gastrointestinal tract infection. C. perfringens virulence is due in large part to toxin production. In 2014, a new enterotoxin, BEC (binary enterotoxin of Clostridium perfringens) encoded by becA and becB genes, distinct from enterotoxin (CPE) encoded by the cpe gene, has been described. BEC-producing strains can be causative agents of acute gastroenteritis in humans. We present herein the case of a 64-year-old man who presented to the emergency department of Toulouse University Hospital with pneumonia and septic shock, without digestive symptoms. Blood cultures showed C. perfringens bacteremia and despite appropriate antibiotic treatment the patient passed away 7 h after admission. The characterization of the strain by whole genome sequencing revealed the presence of typical genes of C. perfringens: plc gene (alpha-toxin, phospholipase C) and pfoA (theta-toxin, perfringolysine). Surprisingly, this strain also harbored becA and becB genes encoding the recently described BEC toxin. Interestingly, alpha-toxin typing of our isolate and other published BEC isolates showed that they belonged to different PLC subtypes, confirming the high genetic diversity of these strains. To our knowledge, it is the first clinical case reporting bacteremia due to a BEC-producing C. perfringens isolate.

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Section: Discussionmentioning

confidence: 99%

Binary Enterotoxin Producing Clostridium perfringens Isolated in Blood Cultures: Case Report and Review of the Literature

Ben Saïd,

Diancourt,

Rabeau

et al. 2024

Microorganisms

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“…Although there was no difference in infection rates of C. difficile among males and females, 52.9% of C. difficile carriers without CDI were colonized by C. difficile carrying the toxin genes. A report from France showed that 53.2% (42/79) of C. difficile carriers without CDI were colonized by C. difficile with the toxin gene [ 12 ], while in Taiwan 52.9% (72/136) of C. difficile carriers without CDI were colonized by C. difficile with the toxin gene [ 13 ]. Few data are available on C. difficile carriers in Japan, so additional studies are needed to investigate the prevalence of toxin positivity among C.difficile carriers.…”

Section: Discussionmentioning

confidence: 99%

Molecular epidemiological analyses of Clostridioides difficile isolates in a university hospital in Japan

Ito,

Tanimoto,

Chiba

et al. 2023

Heliyon

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“…during dialysis sessions that are shorter than a full day but recurrent over a longer time period). Although C. difficile spores can be present in the hospital environment and asymptomatic colonization of C. difficile among staff and patients may occur, the risk of acquiring CDI is clearly related to the length of hospital stay ( 33 , 34 ). A recent report found an increased risk for CDI in family members of discharged hospitalized patients without diagnosed CDI ( 35 ).…”

Section: Discussionmentioning

confidence: 99%

Molecular epidemiology of community‐ and hospital‐associated Clostridioides difficile infections in Jönköping, Sweden, October 2017 – March 2018

Enkirch

Mernelius

Magnusson

et al. 2022

APMIS

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Clostridioides difficile infections (CDIs) in Sweden are mostly hospital-associated (HA) with limited knowledge regarding community-associated (CA) infections. Here, we investigated the molecular epidemiology of clinical isolates of CA-CDI and HA-CDI in a Swedish county. Data and isolates (n = 156) of CDI patients (n = 122) from J€ onk€ oping county, October 2017-March 2018, were collected and classified as CA (without previous hospital care or onset ≤2 days after admission or >12 weeks after discharge from hospital) or HA (onset >3 days after hospital admission or within 4 weeks after discharge). Molecular characterization of isolates included PCR ribotyping (n = 156 isolates) and whole genome sequencing with single nucleotide polymorphisms (SNP) analysis (n = 53 isolates). We classified 47 patients (39%) as CA-CDI and 75 (61%) as HA-CDI. Between CA-CDI and HA-CDI patients, we observed no statistically significant differences regarding gender, age, 30-day mortality or recurrence. Ribotype 005 (RR 3.1; 95% CI: 1.79-5.24) and 020 (RR 2.5; 95% CI: 1.31-4.63) were significantly associated with CA-CDI. SNP analysis identified seven clusters (0-2 SNP difference) involving 17/53 isolates of both CA-CDI and HA-CDI. Molecular epidemiology differed between CA-CDI and HA-CDI and WGS analysis suggests transmission of CDI within and between hospitals and communities.

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One-day prevalence of asymptomatic carriage of toxigenic and non-toxigenic Clostridioides difficile in 10 French hospitals

Cited by 7 publications

References 46 publications

Binary Enterotoxin Producing Clostridium perfringens Isolated in Blood Cultures: Case Report and Review of the Literature

Binary Enterotoxin Producing Clostridium perfringens Isolated in Blood Cultures: Case Report and Review of the Literature

Molecular epidemiological analyses of Clostridioides difficile isolates in a university hospital in Japan

Molecular epidemiology of community‐ and hospital‐associated Clostridioides difficile infections in Jönköping, Sweden, October 2017 – March 2018

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