Risk factors for development of Clostridium difficile infection due to BI/NAP1/027 strain: a meta-analysis

Abstract

Fluoroquinolones and age over 65 years were associated with a higher risk of CDI due to the BI/NAP1/027 strain. Clindamycin was associated with a lower risk of CDI due to BI/NAP1/027.

Fluoroquinolone and Macrolide Exposure Predict Clostridium difficile Infection with the Highly Fluoroquinolone- and Macrolide-Resistant Epidemic C. difficile Strain BI/NAP1/027

“…These studies had somewhat different strain prevalences and antibiotic associations, but a meta-analysis supported fluoroquinolone use as a risk factor for infection with PCR ribotype 027 (REA group BI) (21). The Canadian study (19) most closely resembled the strain epidemiology and antibiotic associations that we found in our study.…”

A MLST Clade 2 Clostridium difficile strain with a variant TcdB induces severe inflammatory and oxidative response associated with mucosal disruption

“…The MIC to fluoroquinolones of strain ICC-45 were lower than those recorded for epidemic NAP1/027 strains [42]. The susceptibility of strain ICC-45 to these antibiotics agrees with the absence of the Thr82Ile transition in GyrA that distinguishes the latter group of strains [43].…”

Antibiotic susceptibility and resistance profiles of Romanian Clostridioides difficile isolates

“…Clindamycin administration was historically defined as a major risk factor for CDI [7]. Presently, it is suggested to represent a lower risk of infection with the major epidemic type PR 027 emerged in the last decades, compared to fluoroquinolones [10,14]. However, high levels of MLS B -resistance are still being reported for other epidemic PRs, such as 001, 017 or 078 [12].…”