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Clostridium difficile in preterm neonates.

Stool specimens from premature neonates over the first month of life were examined for the presence of toxigenic Clostridium difficile and to evaluate a possible correlation between colonization and bowel disorders or prior antibiotic administration. Results showed a high isolation rate (63%) of Clostridium difficile with similar incidence in infants treated or not with antibiotics and with or without bowel disorders. Differentiation among strains according to SDS-PAGE, antibiotic susceptibility patterns and toxin production were useful to reveal cross-contamination. Both toxin-producing and non toxigenic strains were found in the infants' intestines. However, toxigenic strains were only present in infants suffering from bowel disorders and thus treated with oral antibiotics, suggesting that these factors may favour colonization by toxigenic strains.