Clostridium difficile 027 increasing detection in a teaching hospital in Rome, Italy

Over the period from August to December 2013, a total of 430 consecutive fecal samples were collected from 308 symptomatic patients (mean age 61.0 ± 24.9 years, median 68, 54.2% males, 45.8% females) presenting diarrhea and clinical suspicion for C. difficile infection. GDH test resulted positive in 69 (22.4%) patients (mean age 68.5±21.2 years, median 79). Gene Xpert C. difficile assay carried out on stools from these 69 patients indicated tcd gene deletion in 24 patients (46.1%), presumably identifying 027 ribotype. The patients (11 males and 13 females) were older compared with those infected due to other C. difficile strains (75.6 ± 17.1 vs. 64.7 ± 22.4; p=0.042). Therefore in our hospital 7.8% of symptomatic patients tested for C. difficile presumably revealed 027 ribotype. We regard the C. difficile 027 strain as endemic in our hospital, because along five months the 24 identified cases were admitted to 15 wards in different parts of the hospital.