Risk factors for<i>Clostridium difficile</i>infection in the community: a case-control study in patients in general practice, Denmark, 2009–2011

Søes, Lillian Marie; Holt, Hanne Marie; Böttiger, Blenda; Nielsen, Henrik Vedel; Andreasen, Viggo; Kemp, Michael; Olsen, K. E. P.; Ethelberg, Steen; Mølbak, Kåre

doi:10.1017/s0950268813002380

Cited by 26 publications

(15 citation statements)

References 47 publications

(70 reference statements)

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“…Also at Mayo, EPEC topped the list, with EAEC again being the fourth most commonly diagnosed potential agent (EPEC, toxigenic C. difficile, sapovirus, EAEC, norovirus, Campylobacter, and ETEC) [14]. The high rate of EPEC and EAEC detection in the stools of patients-but also in controls-has previously been reported by others [15,16].…”

Section: Discussionmentioning

confidence: 76%

Spectrum of enteropathogens detected by the FilmArray GI Panel in a multicentre study of community-acquired gastroenteritis

Spina

Kerr

Cormican

et al. 2015

Clinical Microbiology and Infection

170

116

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The European, multicentre, quarterly point-prevalence study of community-acquired diarrhoea (EUCODI) analysed stool samples received at ten participating clinical microbiology laboratories (Austria, Finland, France, Germany, Greece, Ireland, Italy, Portugal, Romania, and the UK) in 2014. On four specified days, each local laboratory submitted samples from ≤20 consecutive patients to the Austrian Study Centre for further testing with the FilmArray GI Panel (BioFire Diagnostics, Salt Lake City, UT, USA). Of the 709 samples from as many patients received, 325 (45.8%) tested negative, 268 (37.8%) yielded only one organism, and 116 (16.4%) yielded multiple organisms. Positivity rates ranged from 41% (30 of 73 samples) in France to 74% (59 of 80 samples) in Romania. With the exception of Entamoeba histolytica and Vibrio cholerae, all of the 22 targeted pathogens were detected at least once. Enteropathogenic Escherichia coli, Campylobacter species, toxigenic Clostridium difficile, enteroaggregative E. coli, norovirus and enterotoxigenic E. coli were the six most commonly detected pathogens. When tested according to local protocols, seven of 128 positive samples (5.5%) yielded multiple organisms. Overall, the FilmArray GI Panel detected at least one organism in 54.2% (384/709) of the samples, as compared with 18.1% (128/709) when testing was performed with conventional techniques locally. This underlines the considerable potential of multiplex PCR to improve routine stool diagnostics in community-acquired diarrhoea. Classic culture methods directed at the isolation of specific pathogens are increasingly becoming second-line tools, being deployed when rapid molecular tests give positive results. This optimizes the yield from stool examinations and dramatically improves the timeliness of diagnosis.

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Section: Discussionmentioning

confidence: 76%

Spectrum of enteropathogens detected by the FilmArray GI Panel in a multicentre study of community-acquired gastroenteritis

Spina

Kerr

Cormican

et al. 2015

Clinical Microbiology and Infection

170

116

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“…One previous study reported a 22% incidence (4 out of 18 patients) of Clostridum difficile infection 15. This high incidence might be due to the longer follow-up of this study (at least 4 years) or due to the use of a different antibiotic treatment regime in the 4 patients with a Clostridium infection (2 patients were treated with with dicloxacillin) 16-17…”

Section: Discussionmentioning

confidence: 81%

Efficacy of Antibiotic Suppressive Therapy in Patients with a Prosthetic Joint Infection

Wouthuyzen-Bakker¹,

Nijman

Kampinga³

et al. 2017

J. Bone Joint Infect.

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Introduction: For chronic prosthetic joint infections (PJI), complete removal of the infected prosthesis is necessary in order to cure the infection. Unfortunately, a subgroup of patients is not able to undergo a revision surgery due to high surgical risk. Alternatively, these patients can be treated with antibiotic suppressive therapy (AST) to suppress the infection. Aim: To evaluate the efficacy and tolerability of AST. Methods: We retrospectively collected data (period 2009-2015) from patients with a PJI (of hip, knee or shoulder) who were treated with AST at the University Medical Center Groningen, the Netherlands. AST was defined as antibiotic treatment for PJI that was started after the usual 3 months of antibiotic treatment. The time of follow-up was defined from the time point AST was started. Treatment was considered as failed, when the patient still experienced joint pain, when surgical intervention (debridement, removal, arthrodesis or amputation) was needed to control the infection and/or when death occurred due to the infection. Results: We included 21 patients with a median age of 67 years (range 21 - 88) and with a median follow-up of 21 months (range 3 - 81). Coagulase negative staphylococci (CNS) (n=6), S. aureus (n=6) and polymicrobial flora (n=4) were the most frequently found causative pathogens. Most patients with CNS and S. aureus were treated with minocycline (67%) and clindamycin (83%) as AST, respectively. Overall, treatment was successful in 67% of patients. Failure was due to persistent joint pain (n=1), surgical intervention because of an uncontrolled infection (n=3), and death due the infection (n=3). We observed a treatment success of 90% in patients with a 'standard' prosthesis (n=11), compared to only 50% in patients with a tumor-prosthesis (n=10). Also, treatment was successful in 83% of patients with a CNS as causative microorganism for the infection, compared to 50% in patients with a S. aureus. Patients who failed on AST had a higher ESR in comparison to patients with a successful treatment (mean 73 ± 25SD versus 32 ± 19SD mm/hour (p = 0.007), respectively. 43% of patients experienced side effects and led to a switch of antibiotic treatment or a dose adjustment in almost all of these patients. Conclusions: Removal of the implant remains first choice in patients with chronic PJI. However, AST is a reasonable alternative treatment option in a subgroup of patients with a PJI who are no candidate for revision surgery, in particular in patients with a 'standard' prosthesis and/or CNS as the causative micro-organism.

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“…The isolation of multidrug-resistant hypervirulent Clostridioides difficile PCR ribotype 027 and 078 strains from food animals and retail foods in Canada in 2004 ( 1 – 3 ) coincided with a major outbreak of severe C. difficile infections in humans in Canada and the United Kingdom in the same year ( 4 , 5 ). Further epidemiological evidence has indicated that C. difficile could be a foodborne pathogen, thereby explaining a major fraction of infections acquired in hospitals and the community ( 6 – 8 ). Here, we applied a genome-based strategy to further test such a hypothesis and to determine the genetic features that allow highly virulent strains to move between humans and animals.…”

Section: Announcementmentioning

confidence: 99%

Complete Genome Sequences of Historic Clostridioides difficile Food-Dwelling Ribotype 078 Strains in Canada Identical to That of the Historic Human Clinical Strain M120 in the United Kingdom

Kumar

Davenport

Vuyisich

et al. 2018

Microbiol Resour Announc

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Risk factors forClostridium difficileinfection in the community: a case-control study in patients in general practice, Denmark, 2009–2011

Cited by 26 publications

References 47 publications

Spectrum of enteropathogens detected by the FilmArray GI Panel in a multicentre study of community-acquired gastroenteritis

Spectrum of enteropathogens detected by the FilmArray GI Panel in a multicentre study of community-acquired gastroenteritis

Efficacy of Antibiotic Suppressive Therapy in Patients with a Prosthetic Joint Infection

Complete Genome Sequences of Historic Clostridioides difficile Food-Dwelling Ribotype 078 Strains in Canada Identical to That of the Historic Human Clinical Strain M120 in the United Kingdom

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