CDC EID - SEPT 2013 – Au sommaire notamment: Clostridium difficile Infection Caused by Binary Toxin–Positive Strains. Suggested citation for this article To the Editor: With interest, we read the article by Bacci et al. in which they conclude that Clostridium difficile strains containing the binary toxin gene were associated with a higher case-fatality rate after 30 days, even when the analysis was stratified for PCR ribotype (1).
Although this was an appealing conclusion, in our opinion the study was severely limited by selection bias and confounding by underlying diseases. First, in Danish patients with a C. difficile infection (CDI), isolates were characterized only if they were isolated during outbreaks or from patients with severe diseases or if isolates were found to be moxifloxacin resistant. Therefore, selection bias was likely to occur.
Second, adjustment for concurrent conditions was not performed. In an approach to confirm the findings of Bacci et al. (1), we used data from a cohort study conducted during 2006–2009 in 13 Dutch hospitals (2). Acknowledgment References Table. Antimicrobial Resistance and Infection Control 2013, 2:21 Epidemiology of Clostridium difficile infection in Asia. CDC EID - NOV 2013 - Au sommaire: Possible Association between Obesity and Clostridium difficile Infection. Medscape, LLC is pleased to provide online continuing medical education (CME) for this journal article, allowing clinicians the opportunity to earn CME credit.
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medscape, LLC and Emerging Infectious Diseases. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians. Medscape, LLC designates this Journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. All other clinicians completing this activity will be issued a certificate of participation. Release date: October 16, 2013; Expiration date: October 16, 2014 Learning Objectives Upon completion of this activity, participants will be able to: CME Editor CME Author Charles P. Authors. Enfermedades Infecciosas y Microbiología Clínica 26/09/13 First case of autochthonous Clostridium difficile PCR ribotype 027 detected in Spain ☆
New Microbes and New Infections Volume 8, November 2015, Clostridium difficile infections among adults and children in Mwanza/Tanzania: is it an underappreciated pathogen among immunocompromised patients in sub-Saharan Africa? HPA - 2009 - Clostridium difficile Ribotyping Network for England and Northern Ireland. BO SANTE - Avis du Conseil supérieur d’hygiène publique de France (section des maladies transmissibles) relatif à la maîtrise de la diffusion des infections à Clostridium difficile dans les établissements de santé français (séance du 22 septembre 2006) Eurosurveillance - View Article. We describe an Australia-wide Clostridium difficile outbreak in 2011 and 2012 involving the previously uncommon ribotype 244.
In Western Australia, 14 of 25 cases were community-associated, 11 were detected in patients younger than 65 years, 14 presented to emergency/outpatient departments, and 14 to non-tertiary/community hospitals. Using whole genome sequencing, we confirm ribotype 244 is from the same C. difficile clade as the epidemic ribotype 027. Like ribotype 027, it produces toxins A, B, and binary toxin, however it is fluoroquinolone-susceptible and thousands of single nucleotide variants distinct from ribotype 027. Fifteen outbreak isolates from across Australia were sequenced.
Despite their geographic separation, all were genetically highly related without evidence of geographic clustering, consistent with a point source, for example affecting the national food chain. Introduction Methods Results Figure 1. Figure 2. Figure 3. Table. Figure 4. Figure 5. Discussion References. CDC EID - AOUT 2012 - Au sommaire: Epidemic Clostridium difficile Ribotype 027 in Chile.
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Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 98, No. 4, June, 2003, Prevalence of Clostridium spp. and Clostridium difficile in C. Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 98, No. 4, June, 2003, pp. 451-454.
EUROSURVEILLANCE 12/11/09 Decrease of hypervirulent Clostridium difficile PCR ribotype 027 in the Netherlands. After the first outbreaks of Clostridium difficile PCR ribotype 027 (North American pulsed-field type 1, restriction endonuclease analysis group BI) in the Netherlands in 2005, a national surveillance programme for C. difficile infection (CDI) was started.
Furthermore, national guidelines were developed to rapidly recognise type 027 infections and prevent further spread. The mean incidence of CDI measured in 14 hospitals remained stable throughout the years: an incidence of 18 per 10,000 admissions was seen in 2007 and 2008. Between April 2005 and June 2009 a total of 2,788 samples were available for PCR ribotyping. A decrease was seen in the number and incidence of type 027 after the second half of 2006. In the first half of 2009, the percentage of type 027 isolates among all CDI decreased to 3.0%, whereas type 001 increased to 27.5%. The Figure depicts the distribution of the five most common PCR ribotypes in the Netherlands between April 2005 and June 2009.
Figure. CANADIAN MEDICAL ASSOCIATION 06/07/04 Clostridium difficile infection in hospitals: risk factors and responses. CANADIAN MEDICAL ASSOCIATION 31/08/04 C. difficile hits Sherbrooke, Que., hospital: 100 deaths. Doctors at a Sherbrooke, Que., hospital have lost 100 patients in the last 18 months to Clostridium difficile, the same infection that is dogging wards in Montréal and Calgary hospitals, CMAJ has learned.
Figure. C. difficile, an anaerobic gram-positive rod, is the most frequently identified cause of antibiotic-associated diarrhea, accounting for approximately 15%–25% of all episodes. Photo by: US Centers for Disease Control and Prevention In the first 6 months of this year, 46 patients at the Centre Hospitalier Universitaire de Sherbrooke died within 30 days of being diagnosed with C. difficile-associated diarrhea (CDAD), and 54 patients died in 2003, says Dr.
Jacques Pépin, an infectious disease consultant at the hospital and a professor at Sherbrooke University. He believes this is an under-estimate of the actual incidence, calling it “the worst epidemic of hospital-acquired infections that we've had.” An administrator at the Sherbrooke hospital described the situation as a “crisis.” CANADIAN MEDICAL ASSOCIATION 31/08/04 Les infections nosocomiales : que faut-il faire? «À l'hôpital, on vide l'ambulance et on la désinfecte ensuite à fond.
L'infirmière change ses vêtements extérieurs et on laisse toutes les couvertures à l'hôpital pour qu'elles soient lavées. […] Outre cette désinfection à l'hôpital […] les infirmières et les ambulanciers se lavent et se changent avant de partir. Il n'y a pas lieu de craindre, selon nous, que l'hôpital devienne un foyer d'infection1.» Pendant la majeure partie de leur histoire, les hôpitaux étaient avant tout un refuge pour les démunis et les mourants, un endroit que les riches évitaient. Au XIXe et au début du XXe siècles, ils servaient à traiter (et à contenir) des maladies infectieuses comme la variole (comme dans le cas que l'on vient de citer). Depuis une centaine d'années environ, et particulièrement vers la deuxième moitié du dernier siècle, les hôpitaux sont toutefois devenus une vitrine des miracles de la médecine et des technologies impressionnantes.
CANADIAN MEDICAL ASSOCIATION 28/09/04 Quebec to report on Clostridium difficile in 2005. Quebecers will have to wait until at least February 2005 to find out whether Montréal hospitals facing an outbreak of Clostridium difficile cases in the past 18 months have successfully reduced the infection and death rate.
A surveillance project announced in June — after CMAJ reported that at least 79 infected patients had died in 2003 and early 2004 — got underway Aug. 22. Figure. C. difficile cases: “To difficult to count” Photo by: CDC/Dr. Gilda Jones Quebec's health minister, Dr. Dr. Quebec's public health authorities will use the Internet to collect data on C. difficile from 114 acute care hospitals. “I think a minimum of 6 months is required before we get the whole picture,” Couillard says. Libman says the data should help infection control teams determine whether the infection is lingering in their institution. Dr. Although Libman welcomes the information, he is concerned the new tracking system will burden already overworked infectious disease teams. CDC EID JUIN 2008. Au sommaire: Adult Clostridium difficile–related Hospitalizations, United States, 2000–2005.
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