Improvement of infection control management by routine molecular evaluation of pathogen clusters

Mutters, Nico T.; Heeg, Klaus; Späth, Isabel; Henny, Nicole; Günther, Frank

doi:10.1016/j.diagmicrobio.2017.01.013

Cited by 4 publications

(1 citation statement)

References 16 publications

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“…13,19 The RAPD typing showed high discriminatory power and stability for analysis of these strains 29 This method provide reliable results within one or 2 days and allow for early and more precise implementation of infection control measures. 30 Our results strongly suggest that two major RAPD types of C. difficile, isolated from 53.8% (7/13) and 30.8% (4/13) of the patients, were prevalent circulating strains in this studied diabetic population. These cases occurred as unique endogenous CDI and might be spread by patient to patient transmission.…”

Section: Discussionsupporting

confidence: 64%

Phenotypic and Genotypic Characteristics of Clostridium difficile Isolates in Patients with Type 2 Diabetes in Iran

Shoaei

Shojaei

Shirani

2020

IDR

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This study aimed to investigate the phenotypic and genotypic characterization of Clostridium difficile isolates in type 2 diabetes patients with hospital-acquired diarrhea in four teaching hospitals in Isfahan, Iran. Patients and Methods: A total of 104 hospitalized patients with type 2 diabetes and nosocomial diarrhea were included in the current study over a 2-year period (2015)(2016)(2017). C. difficile isolates were characterized by conventional microbiological methods including the presence of toxin genes, antibiotic resistance testing and molecular methods including multilocus sequence typing (MLST) and random amplification of polymorphic DNA (RAPD). Results: All 21 C. difficile isolates (20.2%) were detected from 104 studied patients. All isolates were susceptible to metronidazole and vancomycin. The antimicrobial resistance rates were distinctly higher for clindamycin and for moxifloxacin. Based on PCR amplification of tcdA and tcdB, 13 isolates (12.5%) carried both of these genes and were considered toxigenic. Thirteen toxigenic C. difficile strains were classified into two sequence types (STs), that is, ST54 and ST2 types. The RAPD-PCR amplification patterns of the detected toxigenic C. difficile revealed three distinct but related RAPD clusters. RAPD cluster 1 had the highest similarity with RAPD types 2 and 3. Conclusion: A relatively high rate of CDI was observed in patients with type 2 diabetes and was associated with poorer health outcomes. These patients were exposed to multiple antibiotics and other therapeutic agents. We recommend close screening for the coexistence of CDI and type 2 diabetes in patients with diarrhea using a combination of conventional and molecular methods.

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Section: Discussionsupporting

confidence: 64%

Phenotypic and Genotypic Characteristics of Clostridium difficile Isolates in Patients with Type 2 Diabetes in Iran

Shoaei

Shojaei

Shirani

2020

IDR

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Transmission of Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae: the role of infection control

Tsioutis

Eichel

Mutters

2021

Journal of Antimicrobial Chemotherapy

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Background The worldwide spread of carbapenemase-producing Gram-negative bacteria (GNB) in healthcare settings is worrying. Of particular concern is the occurrence of Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae (KP). In recent years, several guidelines and recommendations have focused on the control of carbapenem-resistant GNB. It remains, however, unknown to what extent individual infection control measures are effective. Our aim was to critically review the recent evidence regarding the effectiveness of measures to control KPC-KP spread in healthcare settings. Methods Critical review of the literature aiming to evaluate, in accordance with published recommendations, all available studies reporting infection control (IC) measures to control KPC-KP published in the past 5 years. Results Among 11 included studies, the majority consisted of outbreak reports, where application of measures was reported in the absence of control groups. Variability was observed related to the frequency of application of recommended measures for control of KPC-KP. Additional measures were recorded, such as environmental sampling and staff screening, whereas compliance with hand hygiene was measured in relatively few studies. Finally, mortality in patients harbouring KPC-KP was notable, reaching 42.9% of included patients. Conclusions Despite successful control of KPC-KP spread during outbreaks, the impact of individual IC measures is difficult to assess, as the quality of published evidence is low and controlled intervention studies are lacking. The distribution of studies, the number of reported cases and the high mortality rates, clearly show that KPC-KP remains a major healthcare problem worldwide.

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Aspects of Clostridium difficile infection in pigs

Moono¹

2017

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Improvement of infection control management by routine molecular evaluation of pathogen clusters

Cited by 4 publications

References 16 publications

<p>Phenotypic and Genotypic Characteristics of <em>Clostridium difficile</em> Isolates in Patients with Type 2 Diabetes in Iran</p>

<p>Phenotypic and Genotypic Characteristics of <em>Clostridium difficile</em> Isolates in Patients with Type 2 Diabetes in Iran</p>

Transmission of Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae: the role of infection control

Aspects of Clostridium difficile infection in pigs

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