TY - JOUR
T1 - Presence of Clostridioides difficile and multidrug-resistant healthcare-associated pathogens in stool specimens from hospitalized patients in the USA
AU - the Healthcare Associated Infections Consortium
AU - Tickler, I. A.
AU - dela Cruz, C. M.
AU - Obradovich, A. E.
AU - Goering, R. V.
AU - Dewell, S.
AU - Le, V. M.
AU - Tenover, F. C.
AU - Anderson, J.
AU - Banaei, N.
AU - Bankowski, M.
AU - Dill, J. L.
AU - Harrington, A. T.
AU - Henthorne, M. A.
AU - Klutts, J. S.
AU - Koyamatsu, T.
AU - Overcast, R.
AU - Rekasius, V. J.
AU - Rojtman, A.
N1 - Publisher Copyright:
© 2020 The Healthcare Infection Society
PY - 2020/9
Y1 - 2020/9
N2 - Background: Healthcare-associated infections (HCAIs) continue to be a major cause of morbidity and mortality. Many HCAI pathogens, including multidrug-resistant organisms (MDROs), colonize the gastrointestinal tract. Aim: To determine the frequency of MDRO carriage in patients who do and do not harbour toxigenic Clostridioides difficile in their stools. Methods: Stool specimens received from nine US laboratories were cultured using media selective for C. difficile, Staphylococcus aureus, vancomycin-resistant enterococci (VRE), and carbapenem-resistant Gram-negative organisms (CROs). Specimens and isolates were also tested by polymerase chain reaction (PCR). Bacterial isolates underwent susceptibility testing and genotyping. Findings: Among 363 specimens, 175 yielded toxigenic C. difficile isolates spanning 27 PCR ribotypes. C. difficile (TCD+) stools harboured an additional 28 organisms, including six CROs (3.4%), of which two (1.1%) were carbapenemase-producing organisms (CPOs), 19 VRE (10.9%), and three meticillin-resistant S. aureus isolates (MRSA, 1.7 %). Stools that were culture negative for toxigenic C. difficile (TCD–) yielded 26 organisms, including four CROs (2.1%), 20 VRE (10.6), and two MRSA (1.1%). Excluding C. difficile, no significant differences were seen in the rates of the MDROs between TCD+ and TCD– specimens. Conclusion: Overall, 15.4% of the TCD+ stools and 11.2% of the TCD– stools carried at least one non-C. difficile MDRO pathogen, indicating that multiple MDROs may be present in the gastrointestinal tracts of patients, including those that harbour C. difficile.
AB - Background: Healthcare-associated infections (HCAIs) continue to be a major cause of morbidity and mortality. Many HCAI pathogens, including multidrug-resistant organisms (MDROs), colonize the gastrointestinal tract. Aim: To determine the frequency of MDRO carriage in patients who do and do not harbour toxigenic Clostridioides difficile in their stools. Methods: Stool specimens received from nine US laboratories were cultured using media selective for C. difficile, Staphylococcus aureus, vancomycin-resistant enterococci (VRE), and carbapenem-resistant Gram-negative organisms (CROs). Specimens and isolates were also tested by polymerase chain reaction (PCR). Bacterial isolates underwent susceptibility testing and genotyping. Findings: Among 363 specimens, 175 yielded toxigenic C. difficile isolates spanning 27 PCR ribotypes. C. difficile (TCD+) stools harboured an additional 28 organisms, including six CROs (3.4%), of which two (1.1%) were carbapenemase-producing organisms (CPOs), 19 VRE (10.9%), and three meticillin-resistant S. aureus isolates (MRSA, 1.7 %). Stools that were culture negative for toxigenic C. difficile (TCD–) yielded 26 organisms, including four CROs (2.1%), 20 VRE (10.6), and two MRSA (1.1%). Excluding C. difficile, no significant differences were seen in the rates of the MDROs between TCD+ and TCD– specimens. Conclusion: Overall, 15.4% of the TCD+ stools and 11.2% of the TCD– stools carried at least one non-C. difficile MDRO pathogen, indicating that multiple MDROs may be present in the gastrointestinal tracts of patients, including those that harbour C. difficile.
UR - http://www.scopus.com/inward/record.url?scp=85089275686&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85089275686&partnerID=8YFLogxK
U2 - 10.1016/j.jhin.2020.07.003
DO - 10.1016/j.jhin.2020.07.003
M3 - Article
C2 - 32649974
AN - SCOPUS:85089275686
VL - 106
SP - 179
EP - 185
JO - Journal of Hospital Infection
JF - Journal of Hospital Infection
SN - 0195-6701
IS - 1
ER -