Longitudinal survey of Clostridium difficile presence and gut microbiota composition in a Belgian nursing home

• Published in: BMC microbiology Vol. 16; no. 1; p. 229
• Main Authors: Rodriguez, Cristina, Taminiau, Bernard, Korsak, Nicolas, Avesani, Véronique, Van Broeck, Johan, Brach, Philippe, Delmée, Michel, Daube, Georges
• Format: Journal Article
• Language: English
• Published: London BioMed Central 01.10.2016; BioMed Central Ltd; Springer Nature B.V
• Subjects: 16S rRNA gene analysis; Aged; Aged, 80 and over; Anti-Bacterial Agents - therapeutic use; Antibiotics; Belgium - epidemiology; Biodiversity; Biological Microscopy; Biomedical and Life Sciences; C. difficile; Clinical microbiology and vaccines; Clostridium difficile; Clostridium difficile - genetics; Clostridium difficile - isolation & purification; Clostridium Infections - diagnosis; Clostridium Infections - epidemiology; Clostridium Infections - microbiology; Colonization; Diarrhea - microbiology; Elderly care home residents; Feces - microbiology; Female; Gastroenterology & hepatology; Gastroentérologie & hépatologie; Gastrointestinal Microbiome; Health aspects; Human health sciences; Humans; Infections; Life Sciences; Longitudinal method; Longitudinal Studies; Male; Microbiology; Microbiota; Microbiota (Symbiotic organisms); Middle Aged; Mycology; Nursing homes; Nursing Homes - statistics & numerical data; Older people; Parasitology; Physiological aspects; Prevalence; Relative abundance; Research Article; Risk Factors; Sciences de la santé humaine; Virology; Yeast; United States > US; Europe; 16S rRNA gene analysis; Elderly care home residents; C. difficile
• ISSN: 1471-2180; 1471-2180
• DOI: 10.1186/s12866-016-0848-7

Background Increasing age, several co-morbidities, environmental contamination, antibiotic exposure and other intestinal perturbations appear to be the greatest risk factors for C. difficile infection (CDI). Therefore, elderly care home residents are considered particularly vulnerable to the infection. The main objective of this study was to evaluate and follow the prevalence of C. difficile in 23 elderly care home residents weekly during a 4-month period. A C. difficile microbiological detection scheme was performed along with an overall microbial biodiversity study of the faeces content by 16S rRNA gene analysis. Results Seven out of 23 (30.4 %) residents were (at least one week) positive for C. difficile. C. difficile was detected in 14 out of 30 diarrhoeal samples (43.7 %). The most common PCR-ribotype identified was 027. MLVA showed that there was a clonal dissemination of C. difficile strains within the nursing home residents. 16S-profiling analyses revealed that each resident has his own bacterial imprint, which was stable during the entire study. Significant changes were observed in C. difficile positive individuals in the relative abundance of a few bacterial populations, including Lachnospiraceae and Verrucomicrobiaceae. A decrease of Akkermansia in positive subjects to the bacterium was repeatedly found. Conclusions A high C. difficile colonisation in nursing home residents was found, with a predominance of the hypervirulent PCR-ribotype 027. Positive C. difficile status is not associated with microbiota richness or biodiversity reduction in this study. The link between Akkermansia , gut inflammation and C. difficile colonisation merits further investigations.