918. Molecular and Clinical Epidemiology of Clostridium difficile Infection (CDI) in Three Diverse Medical Centers in New York
Session: Poster Abstract Session: Clostridium difficile Infections: Epidemiology and Diagnostics
Friday, October 9, 2015
Room: Poster Hall
Posters
  • IDSAPoster10_01_2015PDF.pdf (412.1 kB)
  • Background:   C. difficile (CD) isolates from patients with hospital acquired CDI can be genetically very diverse.   The purpose of this study was to determine the epidemiology and genetic diversity of all CD isolates from 3 medical centers in the greater New York area. 

    Methods:   During 6 consecutive months, WMC, a tertiary care hospital, ORMC, a large community hospital that refers to WMC , and MSKCC a specialty cancer hospital, collected data for all hospitalized CDI patients, identified by a stool PCR test for C. difficile toxigenic B gene (Cepheid Inc.).  Multilocus sequence typing (MLST) was performed on retrieved toxigenic strains of CD. 

    Results:   The 3 sites varied significantly in patient age, percentages of cases within epidemiologic classifications, previous discharge, severe CDI, and contact precautions duration (Table).   Number of MLST sequence types (ST) isolated were:  34 STs from 124 WMC isolates, 27 STs for 55 ORMC isolates, and 40 STs for 192 MSKCC isolates.  The predominant STs were similar at WMC and ORMC and differed from MSKCC STs (Figures); MSKCC had significantly fewer ST 1 (NAP 1) isolates (9% vs 26%   p=<0.001).      

    Conclusion: Diversity among CD ST was demonstrated for all 3 hospitals. The distribution of STs was similar for the 2 hospitals that transfer patients between them and differed from the cancer specialty hospital where NAP-1 ST and CDI complications were less frequent. .   The STs will be used to further understand CDI transmission and the correlation between ST and epidemiologic definitions and CDI outcome. 

    Marisa Montecalvo, MD1, Mini Kamboj, MD2, Donna Mckenna, ANP MS3, Jonathan Menz, MBA4, Liz Klimczak, RN MS5, Melody Zolendjeski, RN5, Guiqing Wang, MD, PhD6 and Gary Wormser, MD, FIDSA7, (1)Medicine, Infectious Diseases, New York Medical College, Valhalla, NY, (2)Infection Control, Memorial Sloan Kettering Cancer Center, New York, NY, (3)New York Med. Coll., Valhalla, NY, (4)Westchester Medical Center, Valhalla, NY, (5)Orange Regional Medical Center, Middletown, NY, (6)Pathology and Clinical Laboratories, New York Medical College/ Westchester Medical Center, Valhalla, NY, (7)New York Medical College, Valhalla, NY

    Disclosures:

    M. Montecalvo, None

    M. Kamboj, None

    D. Mckenna, None

    J. Menz, None

    L. Klimczak, None

    M. Zolendjeski, None

    G. Wang, None

    G. Wormser, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.