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Clostridium difficile infection in patients with haematological malignant disease: Risk factors, faecal toxins and pathogenic strains

Published online by Cambridge University Press:  19 October 2009

S. R. Heard ,
B. Wren ,
M. J. Barnett ,
J. M. Thomas  and
S. Tabaqchali
S. R. Heard
Affiliation:
Department of Medical Microbiology, St Bartholomew's Hospital, LondonEC1
B. Wren
Affiliation:
Department of Medical Microbiology, St Bartholomew's Hospital, LondonEC1
M. J. Barnett
Affiliation:
Department of Medical Oncology, St Bartholomew's Hospital, LondonEC1
J. M. Thomas
Affiliation:
Department of Computer Studies, St Bartholomew's Hospital, LondonEC1
S. Tabaqchali
Affiliation:
Department of Medical Microbiology, St Bartholomew's Hospital, LondonEC1
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Summary

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Two hundred and forty-eight patients from shared oncology and general medical wards were prospectively studied over a 6-month period for carriage of Clostridium difficile during an outbreak of clinical disease with an epidemic strain of the organism. Risk factors for infection were assessed. Acute leukaemia and/or its treatment were identified as significantly increasing the risk of infection.

The relationship between the type of C. difficile isolated (as defined by a typing system based on the incorporation of [35S]methionine into bacterial proteins followed by gel electrophoresis), the presence of faecal toxins A and B and clinical symptoms were analysed. Carriage of the epidemic strain, type X, had a significant association with symptoms amongst oncology patients, with two thirds of these patients having detectable faecal toxin A and one third detectable faecal toxin B. During an outbreak of C. difficile-associated disease, typing the organism and assaying for both faecal toxins in symptomatic patients may be of benefit in determining which patients require specific, urgent treatment.

Type
Research Article
Information
Epidemiology & Infection , Volume 100 , Issue 1 , February 1988 , pp. 63 - 72
Copyright
Copyright © Cambridge University Press 1988

References

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