Tags

Type your tag names separated by a space and hit enter

Type-specific risk factors and outcome in an outbreak with 2 different Clostridium difficile types simultaneously in 1 hospital.
Clin Infect Dis. 2011 Nov; 53(9):860-9.CI

Abstract

BACKGROUND

Clostridium difficile infection (CDI) due to polymerase chain reaction (PCR) ribotype 027 (type 027) has been described worldwide. In some countries, an increase was reported of toxin A-negative PCR ribotype 017 (type 017). We encountered an outbreak due to these 2 types occurring simultaneously in a 980-bed teaching hospital in the Netherlands.

METHODS

In a case-control study from May 2005 through January 2007, we investigated general and type-specific risk factors as well as outcome parameters for CDI due to type 027 or 017. Clonal dissemination was investigated by multilocus variable number of tandem repeat analysis (MLVA).

RESULTS

We identified 168 CDI patients: 57 (34%) with type 017, 46 (27%) with type 027, and 65 (39%) with 1 of 36 different other types. As controls, we included 77 non-CDI diarrheal patients and 162 patients without diarrhea. Risk factors for CDI were nasogastric intubation, recent hospitalization, and use of cephalosporins and clindamycin. Type-specific risk factors were older age for both types 017 and 027, use of clindamycin and immunosuppressive agents for type 017, and use of fluoroquinolones for type 027. At day 30 of follow-up, the overall mortality among patients with types 017, 027, other types, non-CDI diarrheal patients, and nondiarrheal patients was 23%, 26%, 3%, 2%, and 6%, respectively. MLVA showed persistent clonal dissemination of types 017 and 027, despite appropriate infection control measures.

CONCLUSIONS

Patients with CDI have type-specific risk factors and mortality rates, with prolonged clonal spread of type 027 or 017.

Authors+Show Affiliations

Department of Medical Microbiology, Leiden University Medical Center, The Netherlands. a.goorhuis@lumc.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21914851

Citation

Goorhuis, A, et al. "Type-specific Risk Factors and Outcome in an Outbreak With 2 Different Clostridium Difficile Types Simultaneously in 1 Hospital." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 53, no. 9, 2011, pp. 860-9.
Goorhuis A, Debast SB, Dutilh JC, et al. Type-specific risk factors and outcome in an outbreak with 2 different Clostridium difficile types simultaneously in 1 hospital. Clin Infect Dis. 2011;53(9):860-9.
Goorhuis, A., Debast, S. B., Dutilh, J. C., van Kinschot, C. M., Harmanus, C., Cannegieter, S. C., Hagen, E. C., & Kuijper, E. J. (2011). Type-specific risk factors and outcome in an outbreak with 2 different Clostridium difficile types simultaneously in 1 hospital. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 53(9), 860-9. https://doi.org/10.1093/cid/cir549
Goorhuis A, et al. Type-specific Risk Factors and Outcome in an Outbreak With 2 Different Clostridium Difficile Types Simultaneously in 1 Hospital. Clin Infect Dis. 2011;53(9):860-9. PubMed PMID: 21914851.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Type-specific risk factors and outcome in an outbreak with 2 different Clostridium difficile types simultaneously in 1 hospital. AU - Goorhuis,A, AU - Debast,S B, AU - Dutilh,J C, AU - van Kinschot,C M, AU - Harmanus,C, AU - Cannegieter,S C, AU - Hagen,E C, AU - Kuijper,E J, Y1 - 2011/09/13/ PY - 2011/9/15/entrez PY - 2011/9/15/pubmed PY - 2012/1/24/medline SP - 860 EP - 9 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 53 IS - 9 N2 - BACKGROUND: Clostridium difficile infection (CDI) due to polymerase chain reaction (PCR) ribotype 027 (type 027) has been described worldwide. In some countries, an increase was reported of toxin A-negative PCR ribotype 017 (type 017). We encountered an outbreak due to these 2 types occurring simultaneously in a 980-bed teaching hospital in the Netherlands. METHODS: In a case-control study from May 2005 through January 2007, we investigated general and type-specific risk factors as well as outcome parameters for CDI due to type 027 or 017. Clonal dissemination was investigated by multilocus variable number of tandem repeat analysis (MLVA). RESULTS: We identified 168 CDI patients: 57 (34%) with type 017, 46 (27%) with type 027, and 65 (39%) with 1 of 36 different other types. As controls, we included 77 non-CDI diarrheal patients and 162 patients without diarrhea. Risk factors for CDI were nasogastric intubation, recent hospitalization, and use of cephalosporins and clindamycin. Type-specific risk factors were older age for both types 017 and 027, use of clindamycin and immunosuppressive agents for type 017, and use of fluoroquinolones for type 027. At day 30 of follow-up, the overall mortality among patients with types 017, 027, other types, non-CDI diarrheal patients, and nondiarrheal patients was 23%, 26%, 3%, 2%, and 6%, respectively. MLVA showed persistent clonal dissemination of types 017 and 027, despite appropriate infection control measures. CONCLUSIONS: Patients with CDI have type-specific risk factors and mortality rates, with prolonged clonal spread of type 027 or 017. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/21914851/Type_specific_risk_factors_and_outcome_in_an_outbreak_with_2_different_Clostridium_difficile_types_simultaneously_in_1_hospital_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/cir549 DB - PRIME DP - Unbound Medicine ER -