Colonization by Clostridium difficile in a neonatal intensive care unit [Sulla circolazione di Clostridium difficile in un reparto di terapia intensiva neonatale]

The Authors carried out a prospective study of intestinal colonization by Clostridium difficile on 147 consecutive newborns of a neonatal intensive care unit in Italy. The cumulative risk of Clostridium difficile colonization was 31.3%. Multivariate analysis showed that the probability of Clostridium difficile colonization was statistically associated to duration of hospital stay (OR = 1.025, 95% CI = 1.005 - 1.046; p = 0.014) and previous antibiotic treatment (OR = 3.484, 95% CI = 1.320 - 9.199; p = 0.012). Analysis of restriction pattern of genomic DNA after SmaI digestion and Pulsed Field Gel Electrophoresis (PFGE) of first patient isolates demonstrated a clear clonal spread of the microrganism in the unit. Control of nosocomial Clostridium difficile should be based on the strict adherence to the routinary infection control measures and a well defined antibiotic policy.