Monitoring of Clostridium difficile Colonization in Preterm Infants in Neonatal Intensive Care Units
장주영, 심정옥, 고재성, 서정기, 이진아, 김한석, 최중환, 신수, 신손문,
소속 상세정보
장주영 ( Chang Ju-Young )
서울대학교 보라매병원 소아청소년과
심정옥 ( Shim Jung-Ok )
서울대학교 보라매병원 소아청소년과
고재성 ( Ko Jae-Sung )
서울대학교 보라매병원 소아청소년과
서정기 ( Seo Jeong-Kee )
서울대학교 보라매병원 소아청소년과
이진아 ( Lee Jin-A )
서울대학교 보라매병원 소아청소년과
김한석 ( Kim Han-Suk )
서울대학교 보라매병원 소아청소년과
최중환 ( Choi Jung-Hwan )
서울대학교 보라매병원 소아청소년과
신수 ( Shin Sue )
서울대학교 보라매병원 진단검사의학과
신손문 ( Shin Son-Moon )
관동대학교 의과대학 소아과학교실
KMID : 0816120120150010029
Abstract
Purpose: To examine the prevalence of Clostridium difficile (C. difficile) colonization (CDC) and potential neonatal determinants of CDC in hospitalized preterm infants.
Methods: Fecal samples were serially collected within 72 h after birth and at 1, 2, and 4-6 weeks of age from preterm infants in the neonatal intensive care units (NICUs) of two different university hospitals. Total bacterial DNA was extracted from each fecal sample from 49 infants, and polymerase chain reaction (PCR) was performed with primers for the 16S gene of C. difficile and the toxin A and toxin B genes. The correlation between the results of C. difficile PCR assays and the clinical characteristics of the infants was analyzed.
Results: The prevalence rates of CDC were 34.7, 37.2, 41.3, and 53.1% within 72 h after birth and at 1, 2, and 4?6 weeks of age, respectively. The toxin positivity rate was significantly higher in the infants with persistent CDC than in those with transient CDC (8/12 [66.7%] vs. 6/25 [24.5%] (p=0.001). Among the various neonatal factors, only the feeding method during the first week after birth was significantly associated with persistent CDC. Exclusive breast-milk feeding (EBMF) significantly decreased the risk of persistent CDC compared to formula or mixed feeding (adjusted odds ratio: 0.133, 95% confidence interval: 0.02-0.898, p=0.038).
Conclusion: The prevalence of CDC increased with the duration of hospitalization in preterm infants in the NICU. EBMF during the first week after birth in hospitalized preterm infants may protect against persistent CDC.
키워드
Clostridium difficile; Preterm infants; Breast-milk feeding; NICU
원문 및 링크아웃 정보
등재저널 정보