Mortality attributable to nosocomial Clostridium difficile-associated disease during an epidemic caused by a hypervirulent strain in Quebec

Pépin, Jacques; Valiquette, Louis; Cossette, Benoȋt

doi:10.1503/cmaj.050978

Cited by 553 publications

(367 citation statements)

References 21 publications

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“…1 CDI incidence has also increased in Canada and Europe. [2][3][4] b. There have been numerous reports of an increase in CDI severity.…”

Section: Purposementioning

confidence: 99%

“…There have been numerous reports of an increase in CDI severity. [2][3][4][5][6] c. Most reports of increases in the incidence and severity of CDI have been associated with the BI/NAP1/027 strain of C. difficile. [2][3][4][5][6] This strain produces more toxins A and B in vitro than do many other strains of C. difficile, produces a third toxin (binary toxin), and is highly resistant to fluoroquinolones.…”

Section: Purposementioning

confidence: 99%

“…9 d. CDI has recently been associated with an attributable mortality rate of 6.9% at 30 days after diagnosis and 16.7% at 1 year. 3,4,9 3. Changing risk factors and possible decrease in CDI treatment response rates a. Fluoroquinolones, previously infrequently associated with CDI, have been found to be one of the primary predisposing antimicrobials in recent studies.…”

Section: Purposementioning

confidence: 99%

See 2 more Smart Citations

Strategies to Prevent Clostridium difficile Infections in Acute Care Hospitals

Dubberke

Gerding

Classen

et al. 2008

Infect. Control Hosp. Epidemiol.

189

194

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Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections. The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their Clostridium difficile infection (CDI) prevention efforts. Refer to the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America “Compendium of Strategies to Prevent Healthcare-Associated Infections” Executive Summary and Introduction and accompanying editorial for additional discussion.1. Increasing rates of CDIC. difficile now rivals methicillin-resistant Staphylococcus aureus (MRSA) as the most common organism to cause healthcare-associated infections in the United States.a. In the United States, the proportion of hospital discharges in which the patient received the International Classification of Diseases, Ninth Revision discharge diagnosis code for CDI more than doubled between 2000 and 2003, and CDI rates continued to increase in 2004 and 2005 (L. C. McDonald, MD, personal communication, July 2007). These increases have been seen in pediatric and adult populations, but elderly individuals have been disproportionately affected. CDI incidence has also increased in Canada and Europe.b. There have been numerous reports of an increase in CDI severity.c. Most reports of increases in the incidence and severity of CDI have been associated with the BI/NAP1/027 strain of C. difficile. This strain produces more toxins A and B in vitro than do many other strains of C. difficile, produces a third toxin (binary toxin), and is highly resistant to fluoroquinolones.

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“…1 CDI incidence has also increased in Canada and Europe. [2][3][4] b. There have been numerous reports of an increase in CDI severity.…”

Section: Purposementioning

confidence: 99%

Section: Purposementioning

confidence: 99%

Section: Purposementioning

confidence: 99%

See 1 more Smart Citation

Strategies to Prevent Clostridium difficile Infections in Acute Care Hospitals

Dubberke

Gerding

Classen

et al. 2008

Infect. Control Hosp. Epidemiol.

189

194

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“…The contribution of antibiotics, particularly certain classes (cephalosporins, co-amoxiclav, clindamycin and quinolones), which we have termed 'C. diffogenic' agents (CDAs), to the current epidemic of CDI has been recognised from a variety of studies [13][14][15][16][17][18]. This information and evidence linking the high-level impact of antibiotic restriction combined with strict infection control measures in controlling hospital CDI outbreaks [19][20][21][22][23] supported the development and implementation of national guidance on restriction of CDA antibiotics.…”

Section: Infection Managementmentioning

confidence: 99%

Scottish Antimicrobial Prescribing Group (SAPG): development and impact of the Scottish National Antimicrobial Stewardship Programme

Nathwani

Sneddon²,

Malcolm

et al. 2011

International Journal of Antimicrobial Agents

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“…The rise of 'hypervirulent' ribotype 027 strains has seen an increase in the morbidity and mortality associated with C. difficile 27,28 . Prior to the outbreaks in 2002 and onwards, ribotype 027 strains were not commonly isolated 29 , but are now considered to be one of the most clinically important strain types of C. difficile.…”

mentioning

confidence: 99%

The complex factors that contribute to Clostridium difficile infection

Mackin

Lyras

2015

Microbiol. Aust.

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Over the past decade Clostridium difficile has emerged as a serious public health issue, causing both hospital-based epidemics and community-associated disease. The most commonly recognised cause of antibiotic-associated diarrhoea in the human population, C. difficile was initially seen as a nuisance pathogen causing limited disease in the hospital setting. However, the emergence of ‘hypervirulent' strain types, associated with an increase in both morbidity and mortality, has made it a pathogen of great concern worldwide. Infection with C. difficile is also being increasingly documented in animals, with suggestions that animals destined for human consumption may provide a reservoir for disease. The use of antibiotics is considered the main risk factor for the development of human infection; however, many other factors such as strain type, patient age, and host immune response all contribute to disease caused by C. difficile.

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Mortality attributable to nosocomial Clostridium difficile-associated disease during an epidemic caused by a hypervirulent strain in Quebec

Cited by 553 publications

References 21 publications

Strategies to Prevent Clostridium difficile Infections in Acute Care Hospitals

Strategies to Prevent Clostridium difficile Infections in Acute Care Hospitals

Scottish Antimicrobial Prescribing Group (SAPG): development and impact of the Scottish National Antimicrobial Stewardship Programme

The complex factors that contribute to Clostridium difficile infection

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