The Recent Emergence of Clostridium difficile Infection in Romanian Hospitals is Associated with a High Prevalence of Polymerase Chain Reaction Ribotype 027

Popescu, Gabriel Adrian; Şerban, Roxana; Pistol, Adriana; Niculcea, Andreea; Preda, Andreea; Lemeni, Daniela; Macovei, Ioana; Tălăpan, Daniela; Rafilă, Alexandru; Florea, Dragoș

doi:10.4274/balkanmedj.2017.0400

Cited by 14 publications

(15 citation statements)

References 18 publications

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“…Predictive factors associated with mortality in patients with ribotype 027 infections were high WBC count (22.74 ± 9.75 × 10 9 /l in those who died vs. 14.7 ± 7.07 × 10 9 /l, in those who survived, p = 0.003), high CRP (168.86 ± 61.63 mg/l vs. 97.07 ± 73.96 mg/l, p = 0.006) and creatinine level (209.25 ± 170.03 mg/l vs. 123.06 ± 71.13 mg/l, p = 0.017). (13,14). Study data reflecting the predominance of NAP1/BI/027 infection are in concordance with previously reported prevalence of this ribotype in Serbia and neighboring Bosnia and Herzegovina (4).…”

Section: Resultssupporting

confidence: 91%

Clostridioides difficile ribotype distribution in a large teaching hospital in Serbia

Korać

Rupnik

Nikolić

et al. 2020

Preprint

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Background: The global epidemic of nosocomial diarrhea caused by Clostridioides ( Clostridium) difficile started in 2003, with high mortality rates and emergence of a new hypervirulent strain NAP1/BI/027. The aim of this study was to assess the presence of ribotype 027 and other C. difficile ribotypes in a Serbian University Hospital, to compare the temporal variability of ribotypes three years apart, as well as to compare clinical, demographic and laboratory characteristics and disease outcome among patients infected with 027 and non-027 ribotype. This was a prospective observational study addressing four months time intervals during 2014/2015 and 2017/2018. Results: Ribotyping was performed in 64 non-duplicate C.difficile strains. Ribotype 027 was the most prevalent, and was detected in 53 (82.8%) patients (43/45 and 10/19 patients in 2014-2015 and 2017/2018, respectively). Other detected ribotypes were 001/072 in 4 (6,3%), 002 in 4 (6,3%), 014/020 in 2 (3,1%) and 176 in 1 (1,5%) patient. The percentage of patients infected with ribotype 027 significantly decreased during the three-year period, from 95.6% to 52.6% ( p <0.001). Ribotype 027 infection was associated with fluoroquinolone treatment more frequently than infection with other ribotypes [33 (62.3%) vs. 2 (18.2%), p= 0.010)]. Severe C.difficile infection was diagnosed more often in patients with detected ribotype 027 compared to those infected with non-027 ribotypes (p=0.006). No significant difference in the mortality and recurrence rates was found between patients infected with ribotype 027 and those infected with other ribotypes [10/53 (18.8%) vs. 2/11 (18.2%), p=0.708, and 10/35 (28.6%) vs. 0/2 (0%), p=1.000, respectively]. Conclusion: C. difficile ribotype 027 was the most prevalent ribotype among patients in a large Serbian hospital, but there is a clear decreasing trend.

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Section: Resultssupporting

confidence: 91%

Clostridioides difficile ribotype distribution in a large teaching hospital in Serbia

Korać

Rupnik

Nikolić

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…During the period of 2014/2015, the rate of the patients infected with this ribotype was as high as 95.6%, suggesting that NAP1/BI/027 was the causative agent of the CDI outbreak in Serbia. The high rate of the ribotype 027 infection was also observed in Romania (82.6%) and Poland (82.4%) during 2013/2014 [13,14]. The study results reflecting the predominance of NAP1/BI/027 infection are in accordance with the previously reported data on the distribution of the C. difficile ribotypes in southeastern European countries [4].…”

Section: Resultssupporting

confidence: 90%

Clostridioides difficile ribotype distribution in a large teaching hospital in Serbia

et al. 2020

View full text Add to dashboard Cite

Background: The global epidemic of nosocomial diarrhea caused by Clostridioides (Clostridium) difficile started in 2000, with high mortality rates and emergence of a new hypervirulent strain NAP1/BI/027. The aim of this study was to assess the presence of ribotype 027 and other C. difficile ribotypes in a Serbian University Hospital, compare the temporal variability of ribotypes 3 years apart, as well as to compare clinical, demographic and laboratory characteristics and disease outcome among patients infected with 027 and non-027 ribotype. This was a prospective observational cohort study addressing 4-month intervals during 2014/2015 and 2017/2018. Results: Ribotyping was performed in 64 non-duplicate C. difficile strains. Ribotype 027 was the most prevalent, and was detected in 53 (82.8%) patients (43/45 and 10/19 patients in 2014-2015 and 2017/2018, respectively). Other detected ribotypes were 001/072 in 4 (6.3%), 002 in 4 (6.3%), 014/020 in 2 (3.1%) and 176 in 1 (1.5%) patient. The percentage of the patients infected with ribotype 027 significantly decreased during the 3-year period, from 95.6 to 52.6% (p < 0.001). Ribotype 027 infection was associated with fluoroquinolone treatment more frequently than infection with other ribotypes [33 (62.3%) vs. 2 (18.2%), p = 0.010)]. A severe C. difficile infection was diagnosed more often in patients with the detected ribotype 027 compared to those infected with non-027 ribotypes (p = 0.006). No significant difference in the mortality and recurrence rates was found between the patients infected with ribotype 027 and those infected with other ribotypes [10/53 (18.8%) vs. 2/11 (18.2%), p = 0.708, and 10/35 (28.6%) vs. 0/2 (0%), p = 1.000, respectively]. Conclusion: Clostridium difficile ribotype 027 was the most prevalent ribotype among patients in a large Serbian hospital, but there is a clear decreasing trend.

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“…During the period of 2014/2015, the rate of the patients infected with this ribotype was as high as 95.6%, suggesting that NAP1/BI/027 was the causative agent of the CDI outbreak in Serbia. The high rate of the ribotype 027 infection was also observed in Romania (82.6%) and Poland (82.4%) during 2013/2014 (13,14). The study results reflecting the predominance of NAP1/BI/027 infection are in accordance with the previously reported data on the distribution of the C. difficile ribotypes in southeastern European countries (4).…”

Section: Resultssupporting

confidence: 90%

Clostridioides difficile ribotype distribution in a large teaching hospital in Serbia

Korać

Rupnik

Nikolić

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The global epidemic of nosocomial diarrhea caused by Clostridioides (Clostridium) difficile started in 2000, with high mortality rates and emergence of a new hypervirulent strain NAP1/BI/027. The aim of this study was to assess the presence of ribotype 027 and other C. difficile ribotypes in a Serbian University Hospital, compare the temporal variability of ribotypes three years apart, as well as to compare clinical, demographic and laboratory characteristics and disease outcome among patients infected with 027 and non-027 ribotype. This was a prospective observational cohort study addressing four-month intervals during 2014/2015 and 2017/2018. Results: Ribotyping was performed in 64 non-duplicate C. difficile strains. Ribotype 027 was the most prevalent, and was detected in 53 (82.8%) patients (43/45 and 10/19 patients in 2014-2015 and 2017/2018, respectively). Other detected ribotypes were 001/072 in 4 (6,3%), 002 in 4 (6,3%), 014/020 in 2 (3,1%) and 176 in 1 (1,5%) patient. The percentage of the patients infected with ribotype 027 significantly decreased during the three-year period, from 95.6% to 52.6% (p<0.001). Ribotype 027 infection was associated with fluoroquinolone treatment more frequently than infection with other ribotypes [33 (62.3%) vs. 2 (18.2%), p= 0.010)]. A severe C. difficile infection was diagnosed more often in patients with the detected ribotype 027 compared to those infected with non-027 ribotypes (p=0.006). No significant difference in the mortality and recurrence rates was found between the patients infected with ribotype 027 and those infected with other ribotypes [10/53 (18.8%) vs. 2/11 (18.2%), p=0.708, and 10/35 (28.6%) vs. 0/2 (0%), p=1.000, respectively].Conclusion: C. difficile ribotype 027 was the most prevalent ribotype among patients in a large Serbian hospital, but there is a clear decreasing trend.

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The Recent Emergence of Clostridium difficile Infection in Romanian Hospitals is Associated with a High Prevalence of Polymerase Chain Reaction Ribotype 027

Cited by 14 publications

References 18 publications

Clostridioides difficile ribotype distribution in a large teaching hospital in Serbia

Clostridioides difficile ribotype distribution in a large teaching hospital in Serbia

Clostridioides difficile ribotype distribution in a large teaching hospital in Serbia

Clostridioides difficile ribotype distribution in a large teaching hospital in Serbia

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