A predominantly clonal multi-institutional outbreak of Clostridium difficile-associated diarrhea with high morbidity and mortality.

@article{Loo2005APC,
  title={A predominantly clonal multi-institutional outbreak of Clostridium difficile-associated diarrhea with high morbidity and mortality.},
  author={V. Loo and L. Poirier and Mark Miller and M. Oughton and M. Libman and S. Michaud and A. Bourgault and Tuyen Nguyen and Charles Frenette and Mirabelle Kelly and A. Vibien and P. Brassard and S. Fenn and K. Dewar and T. Hudson and R. Horn and P. René and Y. Monczak and A. Dascal},
  journal={The New England journal of medicine},
  year={2005},
  volume={353 23},
  pages={
          2442-9
        }
}
BACKGROUND In March 2003, several hospitals in Quebec, Canada, noted a marked increase in the incidence of Clostridium difficile-associated diarrhea. METHODS In 2004 we conducted a prospective study at 12 Quebec hospitals to determine the incidence of nosocomial C. difficile-associated diarrhea and its complications and a case-control study to identify risk factors for the disease. Isolates of C. difficile were typed by pulsed-field gel electrophoresis and analyzed for binary toxin genes and… Expand
Molecular Epidemiology and Risk Factors of Clostridium difficile ST81 Infection in a Teaching Hospital in Eastern China
TLDR
Among CDI inpatients, longer hospitalization, usage of prednisolone, suffering from chronic kidney disease or connective tissue diseases and admission to emergency ward 2 or emergency ICU were significant risk factors for ST81 clone infection. Expand
Molecular epidemiology of Clostridium difficile over the course of 10 years in a tertiary care hospital.
TLDR
Years with a high incidence of CDI were associated with large clusters of specific REA types that changed yearly, characterized by a wide diversity of C. difficile types and an ever-changing dominance of specific C. diffuse types over time. Expand
Update on Clostridium difficile associated disease
TLDR
The recent increase in the incidence and severity of Clostridium difficile associated disease may be related, at least in part, to the emergence of a highly virulent, fluoroquinolone-resistant, NAP1/027 strain. Expand
Clostridium difficile strain NAP-1 is not associated with severe disease in a nonepidemic setting.
TLDR
The NAP-1 strain of C difficile was found to cause 25% of cases of CDI in the hospital where the study was performed, however, compared with non-Nap-1 strains, CDI was not associated with increased severity of disease in this nonepidemic setting. Expand
Clostridium difficile associated infection, diarrhea and colitis.
TLDR
The latest information on C. difficile infection, including presentation, vulnerable hosts and choice of antibiotics, alternative therapies, and probiotics and immunotherapy is reviewed to guide healthcare professionals in the difficult decisions that they face when caring for these oftentimes very ill patients. Expand
Clinical Severity of Clostridium difficile PCR Ribotype 027: A Case-Case Study
TLDR
No evidence is found to support previous assertions that ribotype 027 is more virulent than other PCR ribotypes, which raises questions about the contribution of this strain to the recent increase in C. difficile disease throughout North America and Europe. Expand
Characterization of Clostridium difficile Infection and Analysis of Recovered Isolates in a Community Hospital Population in Baltimore, Maryland
TLDR
The epidemic strain of C. difficile (NAP1) constituted a significant proportion of the infections among patients with CDI, and all samples positive for the NAP1 strain were resistant to levofloxacin. Expand
Review: Clostridium difficile-Associated Disorders/Diarrhea and Clostridium difficile Colitis: The Emergence of a More Virulent Era
TLDR
The authors’ conclusions were that a previously uncommon strain of C. difficile with vari- with increased production of toxins A and B was found. Expand
Clostridium Difficile–Associated Diarrhea in a Tertiary Care Medical Center
This retrospective, case-control study aimed to identify variables associated with the incidence of Clostridium difficile–associated diarrhea (CDAD) in acute care facilities and to specificallyExpand
Changing Epidemiology of Clostridium difficile-Associated Disease in Children
TLDR
Findings from this study suggest that the characteristics of CDAD in children—a population that has not been considered to be at high risk for this disease in the past—are changing. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 42 REFERENCES
A Large Outbreak of Clostridium difficile–Associated Disease with an Unexpected Proportion of Deaths and Colectomies at a Teaching Hospital Following Increased Fluoroquinolone Use
TLDR
Investigation of a large C. difficile outbreak in a hospital to identify risk factors and characterize the outbreak found exposure to levofloxacin was an independent risk factor for C. diffuse-associated diarrhea and appeared to contribute substantially to the outbreak. Expand
Clinical and molecular epidemiology of sporadic and clustered cases of nosocomial Clostridium difficile diarrhea.
TLDR
Intense environmental contamination and transmission to close personnel and patient contacts represented coordinated properties of an individual epidemic strain. Expand
Clostridium difficile-associated diarrhea in a region of Quebec from 1991 to 2003: a changing pattern of disease severity
TLDR
An epidemic of CDAD with an increased case-fatality rate has had important consequences on the elderly population of Quebec and the equivalence of vancomycin and metronidazole in the treatment ofCDAD needs to be questioned. Expand
A prospective nationwide study of Clostridium difficile-associated diarrhea in Sweden. The Swedish C. difficile Study Group.
TLDR
The age-specific incidence was little affected by gender but increased > 10-fold over the age range of 60-98 years, and the differences in overall CDAD incidence were sixfold between counties and threefold between major hospitals. Expand
Clostridium difficile-associated diarrhea: epidemiology, risk factors, and infection control.
TLDR
Antibiotic pressure might have contributed to failure of infection control measures to reduce the incidence of CDAD to baseline, and only exposure to antibiotics and prior respiratory tract infections were found to be significant. Expand
Prevalence and pathogenicity of Clostridium difficile in hospitalized patients. A French multicenter study.
TLDR
This multicenter period prevalence study clearly supports the hypothesis of a common role of C difficile in infectious diarrhea in hospitalized patients. Expand
Epidemics of diarrhea caused by a clindamycin-resistant strain of Clostridium difficile in four hospitals.
TLDR
A strain of C. difficile that is highly resistant to clindamycin was responsible for large outbreaks of diarrhea in four hospitals in different states and is a specific risk factor for diarrhea due to this strain. Expand
An epidemic, toxin gene-variant strain of Clostridium difficile.
TLDR
A previously uncommon strain of C. difficile with variations in toxin genes has become more resistant to fluoroquinolones and has emerged as a cause of geographically dispersed outbreaks of C.'s Difficile-associated disease. Expand
Morbidity, Mortality, and Healthcare Burden of Nosocomial Clostridium Difficile-Associated Diarrhea in Canadian Hospitals
TLDR
N-CDAD is a common and serious nosocomial infectious complication in Canada, is associated with substantial morbidity and mortality, and imposes an important financial burden on healthcare institutions. Expand
Clostridium difficile colitis: an increasing hospital-acquired illness.
TLDR
Most cases of C difficile colitis seen by surgeons have followed the use of perioperative prophylactic antibiotics, and the incidence appears to be sharply increasing and is associated with theUse of cephalosporins. Expand
...
1
2
3
4
5
...