An outbreak of Clostridium difficile PCR ribotype 027 in Spain: risk factors for recurrence and a novel treatment strategy

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
E BouzaV de Egea

Abstract

An outbreak of Clostridium difficile infection (CDI) caused by ribotype 027 (B1/NAP1) began in our hospital in November 2014, and produced 141 episodes in the following months. The aim of this study is to describe this outbreak, assess risk factors for recurrence of CDI-027 and to analyze the implementation of a novel treatment strategy. This is a prospective study of all patients with CDI-027, from November 2014 to November 2015. The epidemiological data were collected daily for each patient. We compared clinical characteristics and treatment between patients with and without recurrence of CDI-027. Interestingly, liver cirrhosis was present in 22% of the patients, and most of them received prophylaxis for hepatic encephalopathy with rifaximin. Patients were also taking antimicrobial drugs (93.6%) and proton pump inhibitors (80.1%). Overall, 27 (23.5%) patients had a first recurrence of CDI-027. Liver cirrhosis increased the risk of recurrence (44.4% vs 14.8%). Patients treated with a prolonged oral vancomycin regimen vs the conventional regimen (oral metronidazole or 10 days of vancomycin) had fewer recurrences (8.6 versus 44.7% [p ≤ 0.01]; OR, 0.91; 95% CI, 0.028-0.294) and less attributable mortality (0% versus 7.1%; p = 0.0...Continue Reading

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Citations

Dec 5, 2019·Hepatology International·Vishal C Patel, Roger Williams
Aug 4, 2020·Infectious Diseases·Mazen S BaderJoanna Joyce
Jul 10, 2020·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Ana-Teresa Marques-AfonsoIgnacio Novo-Veleiro
May 20, 2020·Revista española de geriatría y gerontología·Cristina Bermejo BoixareuAntonio Ramos Martínez
May 25, 2021·Enfermedades infecciosas y microbiología clínica·Ángel AsensioUNKNOWN Grupo de trabajo EPINE
Nov 29, 2017·Enfermedades infecciosas y microbiología clínica·Miguel Salavert Lletí

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Methods Mentioned

BETA
PCR
X-ray

Software Mentioned

GeneXpert
PASW Statistics
SPSS

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