• Je něco špatně v tomto záznamu ?

Clostridium difficile ribotype 176 - A predictor for high mortality and risk of nosocomial spread

S. Polivkova, M. Krutova, K. Petrlova, J. Benes, O. Nyc,

. 2016 ; 40 (-) : 35-40. [pub] 20160504

Jazyk angličtina Země Anglie, Velká Británie

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc17013873

PURPOSE: The objective of this survey was to determine the incidence of Clostridium difficile infections (CDI) at the Department of Infectious Diseases, Bulovka Hospital, and to evaluate clinical and epidemiological data on CDI patients together with a detailed molecular characterisation of C. difficile isolates. The patient outcomes were correlated to causative C. difficile PCR-ribotype. METHODS: The twelve-month study (2013) comprised patients two years of age and older with CDI. CDI severity was estimated using ESCMID criteria and ATLAS scoring. C. difficile isolates were further characterized using ribotyping, Multiple-Locus Variable Tandem-Repeats analysis (MLVA) and investigation of antibiotic-resistance determinants (gyrA, gyrB, rpoB, ermB). RESULTS: A total of 619 diarrhoeal stools were investigated. Seventy-two stool samples were GDH and toxin A/B positive, and 39 samples were GDH positive only and subsequently toxigenic C. difficile was cultured. In total, 111 C. difficile isolates were characterized, of which 64 (57.7%) belonged to PCR-ribotype 176. MLVA analysis of PCR-ribotype 176 isolates revealed 11 clonal complexes. Seventy-two isolates (64.9%) showed amino acid substitution Thr82Ile in the GyrA, and sixty-two isolates (55.9%) showed amino acid substitutions Arg505Lys together with His502Asn, or Asp492Glu together with Arg505Lys in the RpoB. Twelve isolates (10.8%) were ermB positive. Severe CDI according to the ESCMID criteria was recorded in forty-two patients (37.8%), and sixteen patients (14.4%) had ATLAS score ≥ 6. Twenty-nine patients (26.1%) had recurrent CDI and twenty-four patients (21.6%) died during the study period. CONCLUSIONS: A higher rate of severe CDI, recurrences and mortality in association with PCR-ribotype 176 infections were observed. The high incidence of PCR-ribotype 176 in the study, and the presence of clonal relatedness between PCR-ribotype 176 isolates, indicate its higher capacity to spread in a hospital setting, which in turn highlights the need to implement strict epidemic measures when PCR-ribotype 176 occurs.

Citace poskytuje Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc17013873
003      
CZ-PrNML
005      
20181211082015.0
007      
ta
008      
170413s2016 enk f 000 0|eng||
009      
AR
024    7_
$a 10.1016/j.anaerobe.2016.05.002 $2 doi
035    __
$a (PubMed)27155489
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a enk
100    1_
$a Polívková, Sylvia $u Department of Infectious Diseases, 3rd Faculty of Medicine, Bulovka Teaching Hospital, Prague, Czech Republic. $7 xx0177482
245    10
$a Clostridium difficile ribotype 176 - A predictor for high mortality and risk of nosocomial spread / $c S. Polivkova, M. Krutova, K. Petrlova, J. Benes, O. Nyc,
520    9_
$a PURPOSE: The objective of this survey was to determine the incidence of Clostridium difficile infections (CDI) at the Department of Infectious Diseases, Bulovka Hospital, and to evaluate clinical and epidemiological data on CDI patients together with a detailed molecular characterisation of C. difficile isolates. The patient outcomes were correlated to causative C. difficile PCR-ribotype. METHODS: The twelve-month study (2013) comprised patients two years of age and older with CDI. CDI severity was estimated using ESCMID criteria and ATLAS scoring. C. difficile isolates were further characterized using ribotyping, Multiple-Locus Variable Tandem-Repeats analysis (MLVA) and investigation of antibiotic-resistance determinants (gyrA, gyrB, rpoB, ermB). RESULTS: A total of 619 diarrhoeal stools were investigated. Seventy-two stool samples were GDH and toxin A/B positive, and 39 samples were GDH positive only and subsequently toxigenic C. difficile was cultured. In total, 111 C. difficile isolates were characterized, of which 64 (57.7%) belonged to PCR-ribotype 176. MLVA analysis of PCR-ribotype 176 isolates revealed 11 clonal complexes. Seventy-two isolates (64.9%) showed amino acid substitution Thr82Ile in the GyrA, and sixty-two isolates (55.9%) showed amino acid substitutions Arg505Lys together with His502Asn, or Asp492Glu together with Arg505Lys in the RpoB. Twelve isolates (10.8%) were ermB positive. Severe CDI according to the ESCMID criteria was recorded in forty-two patients (37.8%), and sixteen patients (14.4%) had ATLAS score ≥ 6. Twenty-nine patients (26.1%) had recurrent CDI and twenty-four patients (21.6%) died during the study period. CONCLUSIONS: A higher rate of severe CDI, recurrences and mortality in association with PCR-ribotype 176 infections were observed. The high incidence of PCR-ribotype 176 in the study, and the presence of clonal relatedness between PCR-ribotype 176 isolates, indicate its higher capacity to spread in a hospital setting, which in turn highlights the need to implement strict epidemic measures when PCR-ribotype 176 occurs.
650    _2
$a mladiství $7 D000293
650    _2
$a dospělí $7 D000328
650    _2
$a senioři $7 D000368
650    _2
$a senioři nad 80 let $7 D000369
650    _2
$a antibakteriální látky $x terapeutické užití $7 D000900
650    _2
$a bakteriální proteiny $x genetika $7 D001426
650    _2
$a dítě $7 D002648
650    _2
$a předškolní dítě $7 D002675
650    _2
$a Clostridioides difficile $x klasifikace $x účinky léků $x genetika $x izolace a purifikace $7 D016360
650    _2
$a infekce spojené se zdravotní péčí $x diagnóza $x farmakoterapie $x mortalita $x patologie $7 D003428
650    _2
$a průjem $x diagnóza $x farmakoterapie $x mortalita $x patologie $7 D003967
650    _2
$a bakteriální léková rezistence $x genetika $7 D024881
650    _2
$a pseudomembranózní enterokolitida $x diagnóza $x farmakoterapie $x mortalita $x patologie $7 D004761
650    _2
$a ženské pohlaví $7 D005260
650    _2
$a exprese genu $7 D015870
650    _2
$a lidé $7 D006801
650    _2
$a mužské pohlaví $7 D008297
650    _2
$a lidé středního věku $7 D008875
650    _2
$a multilokusová sekvenční typizace $7 D058885
650    _2
$a mutace $7 D009154
650    _2
$a retrospektivní studie $7 D012189
650    _2
$a ribotypizace $7 D021521
650    _2
$a stupeň závažnosti nemoci $7 D012720
650    _2
$a analýza přežití $7 D016019
650    _2
$a výsledek terapie $7 D016896
655    _2
$a časopisecké články $7 D016428
700    1_
$a Krůtová, Marcela $u Department of Medical Microbiology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic; DNA Laboratory, Department of Paediatric Neurology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic. Electronic address: marcela.krutova@seznam.cz. $7 xx0191653
700    1_
$a Petrlova, Katarina $u Department of Clinical Microbiology, Bulovka Teaching Hospital, Prague, Czech Republic.
700    1_
$a Beneš, Jiří, $u Department of Infectious Diseases, 3rd Faculty of Medicine, Bulovka Teaching Hospital, Prague, Czech Republic. $d 1954 říjen 12.- $7 jn20000400129
700    1_
$a Nyč, Otakar $u Department of Medical Microbiology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic. $7 uk2007399535
773    0_
$w MED00006567 $t Anaerobe $x 1095-8274 $g Roč. 40, č. - (2016), s. 35-40
856    41
$u https://pubmed.ncbi.nlm.nih.gov/27155489 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y a $z 0
990    __
$a 20170413 $b ABA008
991    __
$a 20181211082139 $b ABA008
999    __
$a ok $b bmc $g 1200338 $s 974651
BAS    __
$a 3
BAS    __
$a PreBMC
BMC    __
$a 2016 $b 40 $c - $d 35-40 $e 20160504 $i 1095-8274 $m Anaerobe $n Anaerobe $x MED00006567
LZP    __
$a Pubmed-20170413

Najít záznam

Citační ukazatele

Možnosti archivace