Details

Autor(en) / Beteiligte

• Loo, Vivian G
• Poirier, Louise
• Miller, Mark A
• Oughton, Matthew
• Libman, Michael D
• Michaud, Sophie
• Bourgault, Anne-Marie
• Nguyen, Tuyen
• Frenette, Charles
• Kelly, Mirabelle
• Vibien, Anne
• Brassard, Paul
• Fenn, Susan
• Dewar, Ken
• Hudson, Thomas J
• Horn, Ruth
• René, Pierre
• Monczak, Yury
• Dascal, André

Titel

A Predominantly Clonal Multi-Institutional Outbreak of Clostridium difficile–Associated Diarrhea with High Morbidity and Mortality

Ist Teil von

• The New England journal of medicine, 2005-12, Vol.353 (23), p.2442-2449

Ort / Verlag

Boston, MA: Massachusetts Medical Society

Erscheinungsjahr

2005

Quelle

MEDLINE

Beschreibungen/Notizen

• In the first half of 2003, the number of C. difficile infections (22.5 per 1000 admissions) increased in Quebec, Canada. This outbreak was associated with fluoroquinolone and cephalosporin use as well as an increase in C. difficile –associated mortality (to 6.9 percent) and colectomy (to 1.9 percent). The outbreak strain was found to have enhanced virulence, as suggested by the presence of binary toxin genes and the partial deletion of a toxin-repressor gene. In the first half of 2003, the number of C. difficile infections (22.5 per 1000 admissions) increased in Quebec, Canada. This outbreak was associated with fluoroquinolone and cephalosporin use as well as an increase in C. difficile –associated mortality and colectomy. Clostridium difficile is the leading cause of nosocomial infectious diarrhea. 1 The most important risk factor for C. difficile –associated diarrhea is prior antibiotic use. 2 Some patients remain asymptomatic after exposure to C. difficile, whereas illness ranging from mild diarrhea to fulminant colitis develops in others. 2 Only 1 to 5 percent of affected patients have severe disease, leading to colectomy, intensive care, or death. 3 , 4 The best-described C. difficile virulence factors are toxins A and B, encoded by the genes tcdA and tcdB, respectively. 5 Together with two regulatory genes ( tcdC and tcdD ) and a porin gene ( tcdE ), . . .