Molecular epidemiology of endemic Clostridioides difficile infection in Japan

Senoh, Mitsutoshi; Kato, Haru

doi:10.1016/j.anaerobe.2021.102510

Cited by 11 publications

(13 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Second, it has inherent limitations such as potential selection bias and confounding factors that could not be accounted for. Third, we were unable to assess the differences in the therapeutic efficacy against strains because ribotyping analysis was not performed in this study, although there have been a few reports on ribotype 027 strain isolates in Japan [ 27 ]. Despite these limitations, there have been no reports comparing the therapeutic outcomes of FDX and oral MNZ treatments for CDI.…”

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy of Fidaxomicin and Oral Metronidazole for Treating Clostridioides difficile Infection and the Associated Recurrence Rate: A Retrospective Cohort Study

Mori,

Hirai,

Ohashi

et al. 2023

Antibiotics

View full text Add to dashboard Cite

Clostridioides difficile infection (CDI) has significant implications for healthcare economics. Although clinical trials have compared fidaxomicin (FDX) and vancomycin, comparisons of FDX and oral metronidazole (MNZ) are limited. Therefore, we compared the therapeutic effects of FDX and oral MNZ. Patients diagnosed with CDI between January 2015 and March 2023 were enrolled. Those treated with oral MNZ or FDX were selected and retrospectively analyzed. The primary outcome was the global cure rate. Secondary outcomes included factors contributing to the CDI global cure rate; the rate of medication change owing to initial treatment failure; and incidence rates of clinical cure, recurrence, and all-cause mortality within 30 days. Of the 264 enrolled patients, 75 and 30 received initial oral MNZ and FDX treatments, respectively. The corresponding CDI global cure rates were 53.3% and 70% (p = 0.12). In multivariate analysis, FDX was not associated with the global cure rate. In the MNZ group, 18.7% of the patients had to change medications owing to initial treatment failure. The FDX group had a higher clinical cure rate and lower recurrence rate than the MNZ group, although not significant. However, caution is necessary owing to necessary treatment changes due to MNZ failure.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy of Fidaxomicin and Oral Metronidazole for Treating Clostridioides difficile Infection and the Associated Recurrence Rate: A Retrospective Cohort Study

Mori,

Hirai,

Ohashi

et al. 2023

Antibiotics

View full text Add to dashboard Cite

show abstract

“…In Japan, the binary toxin-positive isolates (RT027 and 078) were rare (2-6%), with one exception, the RT027 outbreak in 2019. Interestingly, these isolates were moxifloxacin susceptible, suggesting that Japanese RT027 represents the pre-epidemic RT027 genetic background [67]. Data from Africa show that CDI patient populations are often younger than those in Europe, probably due to the high prevalence of co-morbid conditions such as tuberculosis, particularly in sub-Saharan Africa, the main ribotypes are RT012, RT084 and RT014/020 [68].…”

Section: Epidemiologymentioning

confidence: 99%

Clostridioides difficile, a New “Superbug”

et al. 2023

View full text Add to dashboard Cite

Clostridioides difficile is a Gram-positive, spore-forming, anaerobic bacterium. The clinical features of C. difficile infections (CDIs) can vary, ranging from the asymptomatic carriage and mild self-limiting diarrhoea to severe and sometimes fatal pseudomembranous colitis. C. difficile infections (CDIs) are associated with disruption of the gut microbiota caused by antimicrobial agents. The infections are predominantly hospital-acquired, but in the last decades, the CDI patterns have changed. Their prevalence increased, and the proportion of community-acquired CDIs has also increased. This can be associated with the appearance of hypervirulent epidemic isolates of ribotype 027. The COVID-19 pandemic and the associated antibiotic overuse could additionally change the patterns of infections. Treatment of CDIs is a challenge, with only three appropriate antibiotics for use. The wide distribution of C. difficile spores in hospital environments, chronic persistence in some individuals, especially children, and the recent detection of C. difficile in domestic pets can furthermore worsen the situation. “Superbugs” are microorganisms that are both highly virulent and resistant to antibiotics. The aim of this review article is to characterise C. difficile as a new member of the “superbug” family. Due to its worldwide spread, the lack of many treatment options and the high rates of both recurrence and mortality, C. difficile has emerged as a major concern for the healthcare system.

show abstract

“…Uncontrolled prescribing of antimicrobials such as fluoroquinolones and cephalosporins, which are associated with a high risk of C. difficile infection (CDI), creates conditions under which MDR lineages can cause persistent, high-mortality (≥20%) outbreaks ( 9 – 18 ). Such health care-associated transmission may be geographically widespread, as in the “hypervirulent” ST1 ribotype 027 [ST1(027)] lineage FQ-R1 ( 19 ), and/or prolonged, as in ST17(018), predominating in Japanese and Italian health care settings since the 1990s ( 17 , 20 ). Cases associated with the rapid transmission of MDR lineages are typically superimposed on a background of sporadic, unlinked cases caused by diverse C. difficile strains, which lack acquired antimicrobial resistance (AMR) ( 21 , 22 ).…”

Section: Introductionmentioning

confidence: 99%