Isolation of Clostridium difficile from human jejunum: identification of a reservoir for disease?

The possibility that the small intestine may represent a reservoir for Clostridium difficile was studied, using segments of human jejunum collected at necropsy. Our results (three of 100 specimens positive for C difficile culture) support the hypothesis that C difficile can be found in human jejunum and that it adheres to the normal mucosa as a resident bacterium. These findings suggest that gastrointestinal disease caused by C difficile has an endogenous origin.

Evidence for cross-infection in an outbreak of Clostridium difficile-associated diarrhoea in a surgical unit.

Environmental studies were performed in a hospital outbreak of Clostridium difficile-associated diarrhoea. Transmission was associated with the sluice room and the storage room where medical equipment was found to be contaminated with C.difficile. Typing of isolates by antibiotic-susceptibility patterns and profiles of EDTA-extracted proteins showed the presence of an "epidemic" strain common to the majority of patients and environmental sites. Control of the outbreak was achieved by improvement of environmental hygiene and use of disposable equipment.

Anaerobic bacteria in postsurgical infections: isolation rate and antimicrobial susceptibility.

Three hundred clinical samples, obtained from post-surgical infections, were evaluated. 37% of samples were positive for anaerobes, 99 samples (33%) for aerobes and anaerobes in mixed culture, and 13 (4%) only for anaerobes. One hundred forty-nine anaerobic strains were isolated: Bacteroides and Clostridia occurred most frequently (34% and 23% respectively). Antimicrobial susceptibility of the isolates was tested by means of a commercial broth microdilution method. In addition, the standardized agar dilution method was performed to evaluate the susceptibility to 8 antibiotics of the 51 Bacteroides strains.

[The diffusion of salmonellae. Study of a homogeneous sample of 1257 children under 3 years of age in day-nurseries of Rome]. / La diffusione delle salmonelle. Indagine su di un campione omogeneo di 1257 bambini da 0 a 3 anni, negli asili della città di Roma

With a view to examining the importance of healthy carriers in the diffusion of salmonellas, 1257 faeces cultures were examined in a homogeneous population sample, well distributed in the area and considered healthy. The research was carried out between 5th March and 16th June 1975. 5 pathogenic germs were isolated: 2 S. London, 1 S. Wien, 1 S. Blokey and 1 Shigella. The S. Wien proved resistant to several antibiotics. Discussing the technical and epidemiological aspects of this investigation, particularly in relation to the recent epidemic of S. Wien and to the increasing isolation of germs which present polychemoantiobioticoresistance, the importance of the health carrier is stressed along with the need to obtain an antibiogram before therapy to help eliminate germs resistance to several antibiodics.

[Methods for collection, transport and culture media]. / Modalità di prelievo, di trasporto e terreni di coltura.

A crucial factor affecting the ultimate success of anaerobic cultures is a proper specimen collection, with care to avoid inclusion of normal flora often present on human mucosa. In general, material for anaerobic cultures is best obtained using a needle and syringe, from which the air must be expelled. Then the specimens should be placed immediately into an anaerobic transport broth and then in suitable culture pre-reduced media.

[Technics for isolation, incubation and preliminary identification tests]. / Tecniche d'isolamento, d'incubazione e test preliminari d'identificazione.

In this report the AA. emphasize the fact that anaerobes are mostly isolated from mixed cultures in which several bacteria are present. Therefore they suggest to grow all the bacteria under the best conditions and consequently to select the anaerobes from the aerobes. Furthermore they describe the selecting techniques used at Istituto Superiore di Sanità and Clinica Medica III, to attain this aim and enumerate the best methods used for anaerobic incubation.

[Intestinal bacterial flora in normal adults]. / Flora batterica intestinale in adulti normali.

In this preliminary study we have examined 12 healthy men aged between 20-60 years, by three specimens each. All the isolated could be assigned to genera by biochemical tests and gas-liquid chromatography. The results showed a 10(8)/g concentration of aerobe bacteria in faeces and a 10(10)/g concentration of anaerobe non sporing bacteria. The results of the count of Clostridia showed a variability among the examined individuals. The predominant groups of aerobes in the faeces were found to be E. coli and S. faecalis spp. and the predominant group of non sporing anaerobes were Bacteroides and Bificobacteria. These results were similar to the data obtained from foreign AA., showing the predominance of anaerobes in the faeces and particularly of Bacteroides.

[A definitive identification method: gas-liquid chromatography]. / Metodi di identificazione definitiva: cromatografia gas-liquido.

The definitive identification of many anaerobes requires the use of gas-liquid chromatography to detect alcohol and volatile acids end-products of their metabolism. In this study we have used the gas-liquid chromatography for the identification of 360 non sporing anaerobes isolated from faeces of healthy individuals. These analyses were performed on a Variant-Aerograph mod. 2700 gas chromatography fitted with a column without phosphoric acid. The results showed a good percentage of typing (83%).