Toxinogenic Clostridium difficile infection (CDI) is a leading cause of infectious diarrhea. In this retrospective cohort study the molecular epidemiology of hospital-acquired and community-associated CDI was investigated in patients admitted to a tertiary care hospital. CD in stools samples was revealed by a two steps diagnostic algorithm, firstly screening for positivity to GDH antigen and thereafter RT-PCR analysis. Increased CDI incidence was observed ranging from 1.70episodes/10000patient-days in the 1st year, to 2.62 in the 2nd year, mostly hospitalized in the medicine wards, followed by outpatients (5.74 and 5.12episodes/10.000patient-days respectively). CDI positive were older than CDI negative patients and presented increased trend of diarrhea episodes as the patients' age increased. RT-PCR positive patients (n° = 314) were classified according to the CD toxin producing genes in three groups (1-3, carrying tcdB, both tcdB and cdt, and the two genes plus the deletion Δ117 of tcdC, respectively). The incidence of the group 2 and 3 increased statistically with the age of the patients showing correlation with the gender. Higher frequency of patients belonging to group 1 and group 3 was observed in the medical wards. Of note was the high incidence of group 3 in outpatients. Interestingly, patients with previous health care contacts had higher risk (RR = 1.88) of being infected by CD strains with higher toxicity than community patients. Recurrence rate was 15.9%. In conclusion the knowledge of the toxigenic profiles and of their relationships to gender, age and wards distribution may help the clinicians in the clinical management of the disease.

Nosocomial-acquired and community-onset Clostridium difficile infection at an academic hospital in Italy: epidemiology, recurrences and toxin genes distribution / Visconti, Valeria; Brunetti, Grazia; Cuomo, Maria Rosaria; Giordano, Alessandra; Raponi, Giammarco. - In: JOURNAL OF INFECTION AND CHEMOTHERAPY. - ISSN 1341-321X. - STAMPA. - 23:11(2017), pp. 763-768. [10.1016/j.jiac.2017.08.002]

Nosocomial-acquired and community-onset Clostridium difficile infection at an academic hospital in Italy: epidemiology, recurrences and toxin genes distribution

Visconti, Valeria;Brunetti, Grazia;Cuomo, Maria Rosaria;Giordano, Alessandra;Raponi, Giammarco
2017

Abstract

Toxinogenic Clostridium difficile infection (CDI) is a leading cause of infectious diarrhea. In this retrospective cohort study the molecular epidemiology of hospital-acquired and community-associated CDI was investigated in patients admitted to a tertiary care hospital. CD in stools samples was revealed by a two steps diagnostic algorithm, firstly screening for positivity to GDH antigen and thereafter RT-PCR analysis. Increased CDI incidence was observed ranging from 1.70episodes/10000patient-days in the 1st year, to 2.62 in the 2nd year, mostly hospitalized in the medicine wards, followed by outpatients (5.74 and 5.12episodes/10.000patient-days respectively). CDI positive were older than CDI negative patients and presented increased trend of diarrhea episodes as the patients' age increased. RT-PCR positive patients (n° = 314) were classified according to the CD toxin producing genes in three groups (1-3, carrying tcdB, both tcdB and cdt, and the two genes plus the deletion Δ117 of tcdC, respectively). The incidence of the group 2 and 3 increased statistically with the age of the patients showing correlation with the gender. Higher frequency of patients belonging to group 1 and group 3 was observed in the medical wards. Of note was the high incidence of group 3 in outpatients. Interestingly, patients with previous health care contacts had higher risk (RR = 1.88) of being infected by CD strains with higher toxicity than community patients. Recurrence rate was 15.9%. In conclusion the knowledge of the toxigenic profiles and of their relationships to gender, age and wards distribution may help the clinicians in the clinical management of the disease.
2017
cd toxin genes distribution; clostridium difficile infection; community-associated cdi; epidemiology; hospital-acquired infection; recurrences; microbiology (medical); pharmacology (medical); infectious diseases
01 Pubblicazione su rivista::01a Articolo in rivista
Nosocomial-acquired and community-onset Clostridium difficile infection at an academic hospital in Italy: epidemiology, recurrences and toxin genes distribution / Visconti, Valeria; Brunetti, Grazia; Cuomo, Maria Rosaria; Giordano, Alessandra; Raponi, Giammarco. - In: JOURNAL OF INFECTION AND CHEMOTHERAPY. - ISSN 1341-321X. - STAMPA. - 23:11(2017), pp. 763-768. [10.1016/j.jiac.2017.08.002]
File allegati a questo prodotto
File Dimensione Formato  
Visconti_Nosocomial-acquired_2017.pdf

solo gestori archivio

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 402.13 kB
Formato Adobe PDF
402.13 kB Adobe PDF   Contatta l'autore

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1022131
Citazioni
  • ???jsp.display-item.citation.pmc??? 5
  • Scopus 6
  • ???jsp.display-item.citation.isi??? 3
social impact