Monitoring of Clostridium difficile Colonization in Preterm Infants in Neonatal Intensive Care Units.
10.5223/pghn.2012.15.1.29
- Author:
Ju Young CHANG
1
;
Jung Ok SHIM
;
Jae Sung KO
;
Jeong Kee SEO
;
Jin A LEE
;
Han Suk KIM
;
Jung Hwan CHOI
;
Sue SHIN
;
Son Moon SHIN
Author Information
1. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. jkseo@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Clostridium difficile;
Preterm infants;
Breast-milk feeding;
NICU
- MeSH:
Centers for Disease Control and Prevention (U.S.);
Clostridium;
Clostridium difficile;
Colon;
DNA, Bacterial;
Feeding Methods;
Hospitalization;
Hospitals, University;
Humans;
Infant;
Infant, Newborn;
Infant, Premature;
Intensive Care Units, Neonatal;
Intensive Care, Neonatal;
Parturition;
Polymerase Chain Reaction;
Prevalence
- From:Pediatric Gastroenterology, Hepatology & Nutrition
2012;15(1):29-37
- CountryRepublic of Korea
- Language:English
-
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.
