PREVALENCE AND TOXIGENICITY OF CLOSTRIDIUM-DIFFICILE ISOLATES IN FECAL MICROFLORA OF PRETERM INFANTS IN THE INTENSIVE-CARE NURSERY

Fecal isolates of Clostridium difficile and its toxin B were followed prospectively in 50 preterm intensive care nursery (ICN) patients. The first stool specimen was obtained after 1 week of enteral feeding, at 15 +/- 1 days of life, and 2 more specimens were collected at 2-week intervals, 24 +/- 1 and 32 +/- 2 days of life. The stools were culture d for C difficile, and tested for C difficile toxin B. In the first sp ecimen 15% of stools grew C difficile. In the second specimen C diffic ile isolation rates increased to 33% and plateaued. Toxin B was detect ed in 71, 93 and 100% of culture-positive stools in the first, second, and third specimens, respectively. C. difficile colonization was not associated with a higher incidence of necrotizing enterocolitis or dia rrhea, and using precollected, frozen human milk did not protect from C difficile colonization.