Genotyping of Clostridium difficile isolates from a hospital in Warsaw: A preliminary study

Background: Toxigenic Clostridium difficile is the etiologic agent of C. difficile -associated diarrhea. It is believed that patient-to-patient transmission and environmental contamination are risk factors for the spread of this disease in hospitals. The development of precise typing schemes has provided some understanding of the epidemiology of this nosocomial infection. Objective: The purpose of this study was to identify strain types of C. difficile present in the environment of a maternity ward and surgical wards of a hospital in Warsaw, and to correlate these types with those isolated from neonates and surgical patients. Methods: Arbitrarily primed polymerase chain reaction (APPCR), with the arbitrary primer PG-05, was used to genotype 14 isolates of C. difficile obtained from different sources in a hospital in Warsaw. These included clinical isolates from neonates and surgical patients, as well as environmental isolates from the maternity and surgical wards. Results: A predominant toxigenic isolate was found in the maternity environment, and this strain type was also isolated from the stools of two of five newborns. Unique and different DNA banding patterns were observed in the remaining three isolates from neonates. In addition, isolates from an infant with diarrhea also showed a unique AP-PCR type. The isolates from three surgical patients analyzed had the same AP-PCR profile. This type was also found in the surgery ward environment. Conclusion: These data support environmental contamination as an important factor in the etiology of C. difficile -associated diarrhea in this hospital.