Clostridium difficile carriage in hospitalized cancer patients: a prospective investigation in eastern China

BMC Infectious Diseases

Shu-Sen Zheng⁴  Xiao-Zhou Mou⁵  Fan-Long Liu⁴  Xue-Ren Feng¹  Wei-Hua Zou¹  Jing Deng⁴  Yi Zheng⁴  Yu-Long Zheng⁴  Xiao-Gang Chen⁴  Bing-Ru Tian²  Jiong Qian⁴  Peng Zhao⁴  Cai-Yun Fu⁶  Yun Luo³  Da-Zhi Jing³  Wei-Jia Fang⁴ 

[1] Huzhou Central Hospital, Huzhou, China;Department of Oncology, Yuyao Hospital, Yuyao, China;Department of Microbiology, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China;First Affiliated Hospital, School of Medicine, ZheJiang University, 79 Qinchun Road, Hangzhou 310006, China;Zhejiang Provincial People’s Hospital, Hangzhou, China;Lab of Proteomics & Molecular Enzymology, School of Life Sciences, Zhejiang Sci-Tech University, Hangzhou 310018, China

关键词: Hospitalization days;    Age;    Carriage;    Clostridium difficile;   

Others  :  1125487
DOI  :  10.1186/1471-2334-14-523

 received in 2014-07-16, accepted in 2014-09-25,  发布年份 2014

【 摘 要 】

Background

Clostridium difficile carriage has been considered as a potential source for the deadly infection, but its role in cancer patients is still unclear. We aimed to identify the clinical and immunological factors that are related to C. difficile carriage in Chinese cancer patients.

Methods

A total of 400 stool samples were collected from cancer patients who received chemotherapy in three hospitals of eastern China. Bacterial genomic DNA was extracted and two toxin genes (tcdA and tcdB) were detected. PCR ribotyping was performed using capillary gel electrophoresis. Concentrations of prostaglandin E2 (PGE2), transforming growth factor beta (TGF-β) and interleukin-10 (IL-10) were measured using enzyme-linked immunosorbent assay (ELISA) kits.

Results

Eighty-two (20.5%) samples were confirmed to be C. difficile-positive and positive for tpi, tcdA, and tcdB genes. The C. difficile-positive rates in patients with diarrhea and no diarrhea were 35% and 19.7%, respectively (p = 0.09). Patients who were younger than 50 years old and were hospitalized for at least 10 days had a C. difficile-positive rate as high as 35%. In contrast, patients who were older than 50 years old and were hospitalized for less than 10 days had a C. difficile-positive rate of only 12.7% (p = 0.0009). No association was found between C. difficile carriage and chemotherapy regimen, antibiotic drug use, or immunosuppressive mediators, such as prostaglandin E2 (PGE2), transforming growth factor beta (TGF-β), or interleukin-10 (IL-10). Twelve ribotypes of C. difficile were identified, but none of them belonged to ribotype 027.

Conclusions

We conclude that younger patients and those with longer hospitalization stays may be more prone to C. difficile carriage. Studies of larger populations are warranted to clarify the exact role of C. difficile carriage in hospitalized cancer patients in China.

【 授权许可】

   
2014 Fang et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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