Skip to main content
  • ASM
    • Antimicrobial Agents and Chemotherapy
    • Applied and Environmental Microbiology
    • Clinical Microbiology Reviews
    • Clinical and Vaccine Immunology
    • EcoSal Plus
    • Eukaryotic Cell
    • Infection and Immunity
    • Journal of Bacteriology
    • Journal of Clinical Microbiology
    • Journal of Microbiology & Biology Education
    • Journal of Virology
    • mBio
    • Microbiology and Molecular Biology Reviews
    • Microbiology Resource Announcements
    • Microbiology Spectrum
    • Molecular and Cellular Biology
    • mSphere
    • mSystems
  • Log in
  • My alerts
  • My Cart

Main menu

  • Home
  • Articles
    • Current Issue
    • Accepted Manuscripts
    • COVID-19 Special Collection
    • Archive
    • Minireviews
  • For Authors
    • Submit a Manuscript
    • Scope
    • Editorial Policy
    • Submission, Review, & Publication Processes
    • Organization and Format
    • Errata, Author Corrections, Retractions
    • Illustrations and Tables
    • Nomenclature
    • Abbreviations and Conventions
    • Publication Fees
    • Ethics Resources and Policies
  • About the Journal
    • About JCM
    • Editor in Chief
    • Editorial Board
    • For Reviewers
    • For the Media
    • For Librarians
    • For Advertisers
    • Alerts
    • RSS
    • FAQ
  • Subscribe
    • Members
    • Institutions
  • ASM
    • Antimicrobial Agents and Chemotherapy
    • Applied and Environmental Microbiology
    • Clinical Microbiology Reviews
    • Clinical and Vaccine Immunology
    • EcoSal Plus
    • Eukaryotic Cell
    • Infection and Immunity
    • Journal of Bacteriology
    • Journal of Clinical Microbiology
    • Journal of Microbiology & Biology Education
    • Journal of Virology
    • mBio
    • Microbiology and Molecular Biology Reviews
    • Microbiology Resource Announcements
    • Microbiology Spectrum
    • Molecular and Cellular Biology
    • mSphere
    • mSystems

User menu

  • Log in
  • My alerts
  • My Cart

Search

  • Advanced search
Journal of Clinical Microbiology
publisher-logosite-logo

Advanced Search

  • Home
  • Articles
    • Current Issue
    • Accepted Manuscripts
    • COVID-19 Special Collection
    • Archive
    • Minireviews
  • For Authors
    • Submit a Manuscript
    • Scope
    • Editorial Policy
    • Submission, Review, & Publication Processes
    • Organization and Format
    • Errata, Author Corrections, Retractions
    • Illustrations and Tables
    • Nomenclature
    • Abbreviations and Conventions
    • Publication Fees
    • Ethics Resources and Policies
  • About the Journal
    • About JCM
    • Editor in Chief
    • Editorial Board
    • For Reviewers
    • For the Media
    • For Librarians
    • For Advertisers
    • Alerts
    • RSS
    • FAQ
  • Subscribe
    • Members
    • Institutions
LETTERS TO THE EDITOR

Recovery of Clostridium difficile from Hospital Environments

Gayane Martirosian
Gayane Martirosian
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: gmartir@slam.katowice.pl
DOI: 10.1128/JCM.44.3.1202-1203.2006
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

In the paper entitled “Use of a Selective Enrichment Broth to Recover Clostridium difficile from Stool Swabs Stored under Different Conditions” by Arroyo et al., published in the October 2005 issue of the Journal of Clinical Microbiology (1), the authors concluded that the use of selective enriched broth (0.1% sodium taurocholate and cycloserine-cefoxitin fructose broth [TCCFB]) was superior to the use of cycloserine-cefoxitin fructose agar (CCFA) and to the use of alcohol shock followed by inoculation onto blood agar and that neither the storage time nor the storage temperature affected the recovery of C. difficile from stool swabs. This conclusion was based on a comparison of three methods using nine standard culture swabs from each stool sample received in a research laboratory within 1 week of collection. One swab was used immediately, while the remaining swabs were randomly assigned to two storage groups: one at room temperature and the other at 4°C. After 1, 2, 4, and 8 weeks, an appropriate swab from each storage group was inoculated on CCFA and then placed in 9 ml of TCCFB. CCFA was incubated in an anaerobic chamber at 37°C for up to 5 days, and suspicious colonies were subcultured and identified. TCCFB was incubated up to 7 days, and 2 ml was mixed with an equal amount of absolute ethanol and left at room temperature; this procedure was followed by centrifugation and inoculation of the pellet onto blood agar and incubation under an anaerobic condition, as described above.

We used the same 0.1% sodium taurocholate-enriched cycloserine-cefoxitin-amphotericin B mixture (CCA) (bioMerieux, Marcy L'Etoile, France) (TCCA) broth for recovery of C. difficile strains from hospital environmental swabs and from the palms/fingernails of the medical personnel. One hundred sixty-four environmental swabs were collected from hospital environments of maternity (94 swabs) and surgical (70 swabs) wards (5, 6). Environmental samples from a 76-bed maternity ward were collected from neonates' bedrails, baby sinks, baskets for diapers, surfaces of baby-changing tables, baby scales, and walls behind radiators. From a 60-bed surgical ward, environmental samples were collected from patients' beds, stretchers, push-chairs, sinks, and toilets (Table 1). In both hospital wards, C. difficile strains were at the same time isolated from 17% fecal samples of neonates and 9% fecal samples of surgical patients (4). Out of 164 collected environmental swabs inoculated on TCCA Columbia blood agar and subsequently inoculated in TCCA broth, C. difficile strains were isolated in 8 and 12 (13%) cases, respectively, in the maternity hospital and in 3 and 5 (7.4%) cases, respectively, in the surgical ward. Ribotyping classified the majority of C. difficile strains isolated from the maternity environment (type A) and from the surgical environment (type B) in the same fashion. Moreover, ribotyping classified strains from the maternity ward and neonatal fecal samples and from the surgical ward environment and patients' fecal samples as the same types (data not shown). One hundred fifty swab samples taken from the palms/fingernails of medical personnel were C. difficile negative.

Interestingly, the majority of nontoxigenic C. difficile strains did not grow on TCCA Columbia blood agar and were recovered only in TCCA broth.

Because stool samples usually contain a high number of bacterial spores (2), Columbia blood agar with an antibiotic mixture is a good choice when stool samples are cultured within the first 24 to 48 h after collection. When environmental swab samples are cultured for C. difficile, the use of broth enriched with 0.1% sodium taurocholate and an antibiotic mixture is recommended because in the hospital environment, the number of spores is smaller than that in fecal samples. The contamination of the hospital environment may play an important role in transmission, since spores of C. difficile can survive for up to 6 months (3, 8). It is also important from an epidemiological point of view to recognize the source of C. difficile strains and to compare strains isolated from different sources in terms of clonality (7).

View this table:
  • View inline
  • View popup
TABLE 1.

Characteristics of environmental strains of Clostridium difficile isolated from maternity and surgical wards

  • Copyright © 2006 American Society for Microbiology

REFERENCES

  1. 1.↵
    Arroyo, L. G., J. Rousseau, B. M. Willey, D. E. Low, H. Staempfli, A. McGeer, and J. S. Werese. 2005. Use of a selective enrichment broth to recover Clostridium difficile from stool swabs stored under different conditions. J. Clin. Microbiol.43:5341-5343.
    OpenUrlAbstract/FREE Full Text
  2. 2.↵
    Barbut, F., M. Delmee, J. S. Brazier, J. C. Petit, I. R. Poxton, M. Rupnik, V. Lalande, C. Schneider, P. Mastrantonio, R. Alonso, E. Kuipjer, M. Tvede, and the ESMID Study Group on Clostridium difficile (ESGCD). 2003. A European survey of diagnostic methods and testing protocols for Clostridium difficile. Clin. Microbiol. Infect.9:989-996.
    OpenUrlCrossRefPubMedWeb of Science
  3. 3.↵
    Buggy, B. P., C. C. Hawkins, and R. Fekety. 1985. Effect of adding sodium taurocholate to selective media on the recovery of Clostridium difficile from environmental surfaces. J. Clin. Microbiol.21:636-637.
    OpenUrlAbstract/FREE Full Text
  4. 4.↵
    Martirosian, G. 1996. Pseudomembranous colitis: epidemiology, etiology, diagnosis. Ph.D. thesis. Medical University of Warsaw, Warsaw, Poland.
  5. 5.↵
    Martirosian, G., S. Kuipers, H. Verbrugh, A. van Belkum, and F. Meisel-Mikołajczyk. 1995. PCR ribotyping and arbitrarily primed PCR for typing strains of Clostridium difficile from a Polish maternity hospital. J. Clin. Microbiol.33:2016-2021.
    OpenUrlAbstract/FREE Full Text
  6. 6.↵
    Martirosian, G., J. Polański, A. Szubert, and F. Meisel-Mikołajczyk. 1993. C. difficile in a department of surgery. Mater. Med. Pol.25:145-147.
    OpenUrlPubMed
  7. 7.↵
    Rexach, C. E., Y. J. Tang-Feldman, and S. H. Cohen. 2005. Spatial and temporal analysis of Clostridium difficile infection in patients at a pediatric hospital in California. Infect. Control Hosp. Epidemiol.26:691-696.
    OpenUrlCrossRefPubMed
  8. 8.↵
    Wilson, K. H., M. J. Kennedy, and F. R. Fekety. 1982. Use of sodium taurocholate to enhance spore recovery on a medium selective for Clostridium difficile. J. Clin. Microbiol.15:443-446.
    OpenUrlAbstract/FREE Full Text
PreviousNext
Back to top
Download PDF
Citation Tools
Recovery of Clostridium difficile from Hospital Environments
Gayane Martirosian
Journal of Clinical Microbiology Mar 2006, 44 (3) 1202-1203; DOI: 10.1128/JCM.44.3.1202-1203.2006

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Print

Alerts
Sign In to Email Alerts with your Email Address
Email

Thank you for sharing this Journal of Clinical Microbiology article.

NOTE: We request your email address only to inform the recipient that it was you who recommended this article, and that it is not junk mail. We do not retain these email addresses.

Enter multiple addresses on separate lines or separate them with commas.
Recovery of Clostridium difficile from Hospital Environments
(Your Name) has forwarded a page to you from Journal of Clinical Microbiology
(Your Name) thought you would be interested in this article in Journal of Clinical Microbiology.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Share
Recovery of Clostridium difficile from Hospital Environments
Gayane Martirosian
Journal of Clinical Microbiology Mar 2006, 44 (3) 1202-1203; DOI: 10.1128/JCM.44.3.1202-1203.2006
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Top
  • Article
    • REFERENCES
  • Figures & Data
  • Info & Metrics
  • PDF

KEYWORDS

Clostridium difficile
environmental microbiology

Related Articles

Cited By...

About

  • About JCM
  • Editor in Chief
  • Board of Editors
  • Editor Conflicts of Interest
  • For Reviewers
  • For the Media
  • For Librarians
  • For Advertisers
  • Alerts
  • RSS
  • FAQ
  • Permissions
  • Journal Announcements

Authors

  • ASM Author Center
  • Submit a Manuscript
  • Article Types
  • Resources for Clinical Microbiologists
  • Ethics
  • Contact Us

Follow #JClinMicro

@ASMicrobiology

       

ASM Journals

ASM journals are the most prominent publications in the field, delivering up-to-date and authoritative coverage of both basic and clinical microbiology.

About ASM | Contact Us | Press Room

 

ASM is a member of

Scientific Society Publisher Alliance

 

American Society for Microbiology
1752 N St. NW
Washington, DC 20036
Phone: (202) 737-3600

 

Copyright © 2021 American Society for Microbiology | Privacy Policy | Website feedback

Print ISSN: 0095-1137; Online ISSN: 1098-660X