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Int J Med Microbiol. 2016 Dec;306(8):652-656. doi: 10.1016/j.ijmm.2016.09.004. Epub 2016 Sep 24.

High prevalence of nontoxigenic Clostridium difficile isolated from hospitalized and non-hospitalized individuals in rural Ghana.

Author information

1
University Medical Center Göttingen, Institute of Medical Microbiology, Kreuzbergring 57, D37075 Göttingen, Germany.
2
St. Martin de Porres Hospital, Eikwe, W/R, Ghana.
3
University of Maribor, Faculty of Medicine, Taborska 8, SVN2000 Maribor, Slovenia; National Laboratory for Health, Environment and Food (NLZOH), Prvomajska 1, SVN 2000 Maribor, Slovenia.
4
University Medical Center Göttingen, Institute of Medical Microbiology, Kreuzbergring 57, D37075 Göttingen, Germany; Göttingen International Health Network, Göttingen, Germany. Electronic address: ugross@gwdg.de.

Abstract

Since data about Clostridium difficile infection in sub-Saharan Africa are scarce, we determined its epidemiology and risk factors in a cross-sectional study in Eikwe, a rural community in Ghana. We tested stool samples from 176 hospitalized patients with diarrhoea and from 131 asymptomatic non-hospitalized individuals for C. difficile and some other enteric pathogens. The overall prevalence rate of C. difficile was 4.9% with ribotype 084 being predominant. With 75% of the isolates, a high rate of nontoxigenic strains was present in symptomatic patients, most of whom had no other identified enteric pathogens. All strains were susceptible against metronidazole and vancomycin, respectively. Data on lifestyle and medical history showed that age <5years (p=0.004), and use of ceftriaxone (p=0.023) were the most important risk factors for C. difficile carriage status. Although our data suggest that C. difficile is currently not a major cause of diarrhoea in this setting, the epidemiology of C. difficile in sub-Saharan Africa awaits further investigation.

KEYWORDS:

Africa; Clostridium difficile; Epidemiology; Nontoxigenic strain

PMID:
27693000
DOI:
10.1016/j.ijmm.2016.09.004
[Indexed for MEDLINE]

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