Prevalence of Clostridium difficile in Hospital Environment within Yola Adamawa State Nigeria

Introduction: Clostridium difficile infection (CDI) is an emerging health problem in hospital setting. The ability of the spores to persist in the environment is a key factor in rates of infection. Clostridium difficile has also been described as one of the leading cause of nosocomial diarrhea. It is responsible for an increase in hospital stay with high healthcare and economic repercussions. Objectives: This study was aimed at determining the prevalence and antimicrobial susceptibility profile of Clostridium difficile isolated from surfaces within hospital environment in Yola Adamawa State Nigeria. Materials and Methods: A total of 150 surface samples were collected from different wards of two hospitals (Specialist Hospital Yola (SHY) and Federal Medical Centre Yola (FMCY)) using moistened swabs. Clostridium difficile isolates were obtained by enriching and culturing samples in cycloserine-cefoxitin fructose broth (CCFB) and cycloserine-cefoxitin fructose agar (CCFA) respectively. Susceptibility test (MIC determination) was done by well diffusion technique on Mueller Hinton agar supplemented with 5% sodium taurocholate. Results: A total of 18 (12%) Clostridium difficile were recovered from the two hospitals sampled. FMC had a prevalence rate of 13.3% with table top, toilet, window and bed sheets as sites implicated while SHY had a prevalence rate of 10.7% with bed sheet, bed railing and window as implicated sites. The antibiotic susceptibility test reveals that Clostridium difficile isolates obtained were resistant to the antibiotics tested which includes Ciprofloxacin (MIC >64 µg/ml), Erythromycin (MIC >64 µg/ml), Metronidazole (MIC 64 µg/ml), Tetracycline (MIC > 128 µg/ml) and Clindamycin (MIC > 64 µg/ml). Conclusions: The study depicts that multidrug resistant Clostridium difficile is prevalent in hospital environments within Yola Adamawa State Nigeria. The need for the sensitization of healthcare workers to improve understanding of Clostridium difficile transmission, treatment, management and prevention is of paramount importance.