Analysis of carriage and transmission of Clostridium difficile

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In addition of the last year, another one group of healthy individuals(n=33,age range,20-29) was examined for colonization of Clostridium difficile a total of 3 times at intervals of 3 months. Isolates were analyzed by PCR ribotyping and pulsed-field gel electrophoresis(PFGE) to investigate the colonization status of C.difficile. Moreover, intestinal microflora of C.difficile-positive and -negative subjects was compared. 1.Colonization of C.difficile : C.difficile was isolated from nine(9.1%) of 99 samples. Colonization rates were 9.1% at all three examinations and were similar to those in previous study. Among the four positive subjects, the number of subjects from whom C.difficile was isolated once, twice, three times was two, one and one, respectively. 2.Colonization status of C.difficile : All nine isolates form four specimens were analyzed by PCR ribotyping and PFGE. C.difficile of the same PCR ribotype/PFGE type of were isolated from three subjects. The PCR ribotype/PFGE type of the isolated from a subject at the another examination was changing. 3.Comparison of intestinal micro flora : Composition of feacal micro flora was compared in C.difficile-positive(n=12) and -negative(n=12) subjects. C.difficile-positive subjects were significantly more densely colonized by enterococci than C.difficile-negative subjects. These results suggest that colonization of healthy individuals by C.difficile・is transient in many cases, however, indicates that there are healthy individuals who were continuously colonized by C.difficile. Moreover, these data suggest that dense colonization of the intestine by enterococci may be associated with C.difficile colonization.