Poster Presentation Australian Society for Microbiology Annual Scientific Meeting 2019

Isolation of Clostridium difficile from paediatric patients in Western Australia (#222)

Sicilia Perumalsamy 1 , Thomas Riley 1 2 3 4
  1. School of Biomedical Sciences, University of Western Australia, Perth, WA, Australia
  2. School of Veterinary and Life Sciences , Murdoch University, Perth, WA, Australia
  3. Department of Microbiology, Pathwest Laboratory Medicine , Perth, WA, Australia
  4. School of Medical and Health Sciences , Edith Cowan University, Joondalup, WA, Australia

Introduction

Clostridium difficile is an anaerobic, Gram positive, spore forming rod, the most common cause of hospital-acquired diarrhoea in adults in the developed world. Research on C. difficile infection (CDI) among paediatric patients is limited. Epidemiological typing of C. difficile isolates conducted in Western Australia (WA), between 2011 and 2012 revealed an increasing number of CDI cases in children with malignancy.

Objective

The aim of this study was to analyse the molecular epidemiology of CDI in paediatric patients in WA over a period of a year, a period of time when patients were at Princess Margaret Hospital (PMH) in the first half of the year, and were then moved to Perth Children’s Hospital (PCH) for the second half of the year.

Methods

This was a retrospective study, examining stool PCR positive C. difficile and ribotyping data for the positive stool samples recorded during 2018 (1st January to 28th December). For 1st January to 9th June, data came from PMH and for 13th June to 28th December, the newly opened PCH.

Results

A total of 31 stool samples (from 25 patients) were PCR positive for C. difficile at PMH, for patients aged between 1 to 17 years, from 11 different wards (with the highest prevalence recorded from the oncology ward, followed by the emergency ward). A total of 53 stool samples (from 31 patients) were PCR positive for C. difficile at PCH, for patients aged 6 months to 16 years, from 13 different wards (with the highest prevalence recorded from the haematology/oncology ward). The most common ribotypes (RTs) isolated were toxigenic RTs 020, 014, 106 and 056.  

Conclusions

An increase in prevalence was observed in patients at PCH, when compared to PMH. Understanding the importance of isolating C. difficile (particularly toxigenic strains) in young children and the implications this has on their treatment is significant in aiding the development of effective laboratory testing strategies for CDI in children.