Clostridium difficile ribotype 027 is most prevalent among inpatients admitted from long-term care facilities

Intestinal inflammation was evaluated using faecal lactoferrin and ribotype in 196 hospitalized adults with Clostridium difficile infection to determine the impact of ribotype 027 in long-term care facilities (LTCFs). LTCF residents (n = 28) had greater antibiotic use (P = 0.049) and more ribotype 027 infection [odds ratio (OR): 4.87; 95% confidence interval (CI): 2.02-11.74; P < 0.01], compared to those admitted from home. Patients infected with ribotype 027 strains had worse six-month mortality (OR: 1.90; 95% CI: 1.08-3.34; P = 0.03) and more inflammation (95.26 vs 36.08 mg/mL; P = 0.006), compared to those infected with non-027 strains. This study was not designed to determine acquisition site, but, in this population, suggests that the location from which the patient has been admitted is strongly associated with ribotype 027 and more severe C. difficile disease. (C) 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.