High morbidity and mortality of Clostridium difficile infection and its associations with ribotype 002 in Hong Kong - 10/07/16
Summary |
Objectives |
We aim to study the disease burden, risk factors and severity of Clostridium difficile infection (CDI) in Hong Kong.
Methods |
We conducted a prospective, case–control study in three acute-care hospitals in Hong Kong. Adult inpatients who developed CDI diarrhoea confirmed by PCR (n = 139) were compared with the non-CDI controls (n = 114). Ribotyping of isolates and antimicrobial susceptibility testing were performed.
Results |
The estimated crude annual incidence of CDI was 23–33/100,000 population, and 133–207/100,000 population among those aged ≥65 years. The mean age of CDI patients was 71.5. Nursing home care, recent hospitalization, antibiotics exposure (adjusted OR 3.0, 95% CI 1.3–7.1) and proton-pump inhibitors use (adjusted OR 2.2, 95% CI 1.2–3.9) were risk factors. Severe CDI occurred in 41.7%. Overall mortality was 16.5% (among severe CDI, 26.5%). The commonest ribotypes were 002 (22.8%), 014 (14.1%), 012 and 046; ribotype 027 was absent. Ribotype 002 was associated with fluoroquinolone resistance and higher mortality (47.6% vs. 12.7%; adjusted HR 2.8, 95% CI 1.1–7.0).
Conclusions |
Our findings show high morbidity and mortality of CDI in the older adults, and identify ribotype 002 as a possible virulent strain causing serious infections in this cohort.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Clostridium difficile infection (CDI) is a major disease burden in Asia. |
• | The ribotype 027 is uncommon among CDI patients in Hong Kong. |
• | The ribotype 002 is a virulent strain associated with high mortality. |
Keywords : Clostridium difficile infection, Colitis, Ribotype, Proton-pump inhibitors, Antibiotics
Abbreviations : CDI, CI, CLSI, ESBL, HR, IDSA, OR, PCR, PPI, SHEA
Plan
Vol 73 - N° 2
P. 115-122 - août 2016 Retour au numéro
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