Epidemiology of Clostridium difficile infections in a tertiary-care hospital in Korea.
Clin Microbiol Infect. 2012 May 21;
Authors: Kim J, Kang JO, Kim H, Seo MR, Choi TY, Pai H, Kuijper EJ, Sanders I, Fawley W
Clin Microbiol Infect ABSTRACT: To survey healthcare-associated Clostridium difficile infection (HA-CDI) in a 900-bed tertiary-care hospital, we prospectively investigated the epidemiology of CDI and distribution of PCR-ribotypes. From February 2009 through January 2010, all patients with HA-CDI were enrolled. Epidemiological information and prescription records for antibiotics were collected. The C.Ã¢ÂÂdifficile isolates were characterized using reference strains and were tested for antibiotic susceptibility. During the survey, incidence of HA-CDI was 71.6 per 100Ã¢ÂÂ000 patient-days. In total, 140 C.ÃÂ difficile isolates were obtained from 166 patients with HA-CDI. The PCR-ribotyping yielded 38 distinct ribotypes. The three most frequently found ribotypes made up 56.4% of all isolates; they comprised 37 isolates (26.4%) of PCR-ribotype 018, 22 (15.7%) of toxin A-negative PCR-ribotype 017, and 20 (14.3%) of PCR-ribotype 001. Clostridium difficile PCR-ribotype 018 was present in all departments throughout the hospital during the 11Ã¢ÂÂmonths, whereas ribotype 017 and ribotype 001 appeared mostly in the pulmonary department. Hypervirulent C.ÃÂ difficile PCR-ribotype 027 was detected in 1Ã¢ÂÂmonth on two wards. The incidence of CDI in each department showed a seven-fold difference, which correlated significantly with the amount of prescribed clindamycin (RÃ¢ÂÂ=Ã¢ÂÂ0.783, pÃ¢ÂÂ0.013) or moxifloxacin (RÃ¢ÂÂ=Ã¢ÂÂ0.733, pÃ¢ÂÂ0.025) in the departments. The rates of resistance of the three commonest ribotypes to clindamycin and moxifloxacin were significantly higher than those of other strains (92.1% versus 38.2% and 89.5% versus 27.3%, respectively). CDI is an important nosocomially acquired infection and this study emphasizes the importance of implementing country-wide surveillance to detect and control CDI in Korea.
PMID: 22712697 [PubMed - as supplied by publisher]Link to Article at PubMed