Molecular characteristics of Clostridium difficile infection in diarrhea inpatients in Fuyang district of Hangzhou, Zhejiang

ObjectiveTo investigate current infection status of Clostridium difficile in hospitalized patients with diarrhea in Fuyang district of Hangzhou, Zhejiang province. Molecular characteristics of C. difficile isolates and risk factors of the patients were analyzed.

MethodsA total of 228 stool samples were collected the diarrhea patients in our hospital from May 2017 to February 2018. C. difficile strains isolation and identification were performed by using anaerobic culture. The isolates were typed by multilocus sequence typing. The antibiotic resistance test was performed by using agar dilution assay. The clinical data were statistically analyzed.

ResultsForty one strains of toxigenic C. difficile were isolated from 228 stool samples, in which 31 strains of C. difficile were from patients with hospital acquired diarrhea. The average age of the patients was 67.8 years, the patients were mainly from departments of gastroenterology (34.1%) and nephrology (19.5%). ST2, ST3 and ST54 were the major sequence types. All the isolates were sensitive to metronidazole, vancomycin, tetracycline, and piperacillin. The results of clinical data analysis showed that more diarrhea patients who were aged ＞60 years, had underlying diseases and used antibiotics within 8 weeks were infected with C. difficile（χ²＝4.229, 9.022, 5.767, P＝0.023, 0.001, 0.009）.

ConclusionC. difficile infection mainly occurred in hospitalized diarrhea patients in Fuyang. Old age, underlying disease and antibiotic use within 8 weeks were the risk factors for C. difficile infection. This study indicated that C. difficile surveillance needs to be further strengthened in the prevention and control of nosocomial infection.