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Epidemiology of Clostridium difficile infections in a tertiary-care hospital in Korea.
Clin Microbiol Infect. 2013 Jun; 19(6):521-7.CM

Abstract

To survey healthcare-associated Clostridium difficile infection (HA-CDI) in a 900-bed tertiary-care hospital, we prospectively investigated the epidemiology of CDI and distribution of PCR-ribotypes. From February 2009 through January 2010, all patients with HA-CDI were enrolled. Epidemiological information and prescription records for antibiotics were collected. The C. difficile isolates were characterized using reference strains and were tested for antibiotic susceptibility. During the survey, incidence of HA-CDI was 71.6 per 100 000 patient-days. In total, 140 C. difficile isolates were obtained from 166 patients with HA-CDI. The PCR-ribotyping yielded 38 distinct ribotypes. The three most frequently found ribotypes made up 56.4% of all isolates; they comprised 37 isolates (26.4%) of PCR-ribotype 018, 22 (15.7%) of toxin A-negative PCR-ribotype 017, and 20 (14.3%) of PCR-ribotype 001. Clostridium difficile PCR-ribotype 018 was present in all departments throughout the hospital during the 11 months, whereas ribotype 017 and ribotype 001 appeared mostly in the pulmonary department. Hypervirulent C. difficile PCR-ribotype 027 was detected in 1 month on two wards. The incidence of CDI in each department showed a seven-fold difference, which correlated significantly with the amount of prescribed clindamycin (R = 0.783, p 0.013) or moxifloxacin (R = 0.733, p 0.025) in the departments. The rates of resistance of the three commonest ribotypes to clindamycin and moxifloxacin were significantly higher than those of other strains (92.1% versus 38.2% and 89.5% versus 27.3%, respectively). CDI is an important nosocomially acquired infection and this study emphasizes the importance of implementing country-wide surveillance to detect and control CDI in Korea.

Authors+Show Affiliations

Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Korea.No affiliation info availableNo 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

22712697

Citation

Kim, J, et al. "Epidemiology of Clostridium Difficile Infections in a Tertiary-care Hospital in Korea." Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, vol. 19, no. 6, 2013, pp. 521-7.
Kim J, Kang JO, Kim H, et al. Epidemiology of Clostridium difficile infections in a tertiary-care hospital in Korea. Clin Microbiol Infect. 2013;19(6):521-7.
Kim, J., Kang, J. O., Kim, H., Seo, M. R., Choi, T. Y., Pai, H., Kuijper, E. J., Sanders, I., & Fawley, W. (2013). Epidemiology of Clostridium difficile infections in a tertiary-care hospital in Korea. Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, 19(6), 521-7. https://doi.org/10.1111/j.1469-0691.2012.03910.x
Kim J, et al. Epidemiology of Clostridium Difficile Infections in a Tertiary-care Hospital in Korea. Clin Microbiol Infect. 2013;19(6):521-7. PubMed PMID: 22712697.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epidemiology of Clostridium difficile infections in a tertiary-care hospital in Korea. AU - Kim,J, AU - Kang,J O, AU - Kim,H, AU - Seo,M-R, AU - Choi,T Y, AU - Pai,H, AU - Kuijper,E J, AU - Sanders,I, AU - Fawley,W, Y1 - 2012/06/19/ PY - 2012/6/21/entrez PY - 2012/6/21/pubmed PY - 2013/10/23/medline SP - 521 EP - 7 JF - Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases JO - Clin Microbiol Infect VL - 19 IS - 6 N2 - To survey healthcare-associated Clostridium difficile infection (HA-CDI) in a 900-bed tertiary-care hospital, we prospectively investigated the epidemiology of CDI and distribution of PCR-ribotypes. From February 2009 through January 2010, all patients with HA-CDI were enrolled. Epidemiological information and prescription records for antibiotics were collected. The C. difficile isolates were characterized using reference strains and were tested for antibiotic susceptibility. During the survey, incidence of HA-CDI was 71.6 per 100 000 patient-days. In total, 140 C. difficile isolates were obtained from 166 patients with HA-CDI. The PCR-ribotyping yielded 38 distinct ribotypes. The three most frequently found ribotypes made up 56.4% of all isolates; they comprised 37 isolates (26.4%) of PCR-ribotype 018, 22 (15.7%) of toxin A-negative PCR-ribotype 017, and 20 (14.3%) of PCR-ribotype 001. Clostridium difficile PCR-ribotype 018 was present in all departments throughout the hospital during the 11 months, whereas ribotype 017 and ribotype 001 appeared mostly in the pulmonary department. Hypervirulent C. difficile PCR-ribotype 027 was detected in 1 month on two wards. The incidence of CDI in each department showed a seven-fold difference, which correlated significantly with the amount of prescribed clindamycin (R = 0.783, p 0.013) or moxifloxacin (R = 0.733, p 0.025) in the departments. The rates of resistance of the three commonest ribotypes to clindamycin and moxifloxacin were significantly higher than those of other strains (92.1% versus 38.2% and 89.5% versus 27.3%, respectively). CDI is an important nosocomially acquired infection and this study emphasizes the importance of implementing country-wide surveillance to detect and control CDI in Korea. SN - 1469-0691 UR - https://www.unboundmedicine.com/medline/citation/22712697/Epidemiology_of_Clostridium_difficile_infections_in_a_tertiary_care_hospital_in_Korea_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1198-743X(14)61510-X DB - PRIME DP - Unbound Medicine ER -