Epidemiological Characteristics Of Non-diarrhea Children Carry The Clostridium Difficile In Hospital

Objective：Clostridium difficile is strictly anaerobic bacteria and is thecommon pathogens for hospital-acquired diarrhea. Its characteristic sporeresistance to the external environment，plays an important role in the spread ofthe disease. Clostridium difficile can colonize in body. There is a high rate ofcolonization in children and some researches have been showed the carryingrate of hospitalized children, but there is still a lack of relevant data in local.And because of the harsh conditions, only a small number of domesticlaboratories can culture it, rapid method for Clostridium difficile cultured isessential for the clinical laboratory to diagnosis the Clostridium difficileinfection (CDI).The asymptomatic children play an important role in thespread of Clostridium difficile, so it is essential to understand thecharacteristics of the strain in the region’s children. This study intends toestablish a rapid culture method for clinical laboratories,then isolate thebacteria carried by hospitalized children without diarrhea in Shijiazhuangregion.Analysis the same type of strain circulate between children and adultsby the homology analysis.Methods: Compare the modified fast broth incubation method (our labcreated) with the traditional enrichment spore culture method, direct ethanolprocessing method and the ethanol plus sodium taurocholate method in196stool samples, to identify the best cultured method. A total of601stoolsamples from0-18years hospitalized children without diarrhea were collectedfrom October2011to June2012in three hospitals of Shijiazhuang region.Strain was selected by enrichment spore culture method. Toxins A and Bgenes and ribotyping typings of C. difficile were detected by conventionalpolymerase chain reaction (PCR), Ribotyping typing results were analyzedusing Quantity One software. Results: There is no obvious difference between the modified fast brothincubation method and other3kinds of method in culture positive rate (38.3%,37.1%,35.2%,36.1%, P>0.05). Clostridium difficile was isolated in the stoolsof152samples. The overall Clostridium difficile colonization prevalence was25.3%(152/601), The colonization rate of toxigenic strains was18.3%(110/601); The carrying rate of infants under2years and2-18year-oldchildren was20.6%(81/394),34.3%(71/207) repectively, infants under of2years of prodution strains carring rate was lower than those of2-18years oldchildren (14.7%vs25.1%, P<0.05). Twenty-three PCR ribotypies wereidentified, with six PCR Ribotypies accounting for82.2%(125/152) of theisolates. Twelwe types of adult patients with CDAD in addition to SⅩ, S Xi(1strains, respectively), the rest of10types are founded in children.Conclusions: Our study found the modified fast broth incubation methodis suitable for clinical laboratory operation, provides great convenience for theclinical diagnosis of CDI, and can be used as a kind of economic and effectivemethods in clinical Clostridium difficile culture promotion.The carrying rateof children without diarrhea is similar to foreign reports, but the toxigenicstrains carrying rate is higher, and some PCR ribotypies have homology withthe strains caused by adult CDI. These results indicate that the same strainscirculate in adults and in children. Asymptomatic children may thereforeconstitute a reservoir of infectious strains for adults, act as an efficient vectorof Clostridium difficile spores, and pose a threat to the susceptible patients.