A frequent complication of Clostridium difficile infection (CDI) is recurrent disease. The aim of this study was to determine whether early recurrence risk was higher after infection with ribotype 027 (outbreak strain) compared with infection with endemic strain types of C. difficile. Consecutive patients diagnosed with CDI between May 2013 and March 2014 were included (outbreak strain, and non-outbreak strains). Patients who developed recurrent CDI within 30 days after completion of CDI treatment, were compared with patients without a recurrence. Medical charts were reviewed for demographic and clinical characteristics. General practitioners were contacted to complete data about the occurrence of recurrent CDI, and the use of medication after hospital discharge. In total, 135 patients were at risk for the development of recurrent CDI; 74 patients were infected by ribotype 027, and 61 patients by other ribotypes. Thirty-nine patients (29%) developed recurrent CDI within 30 days after completion of CDI treatment. In multivariable analysis, age ≥70 years (HR 3.05, 95% CI 1.54-6.03), and a duration of CDI treatment ≥11 days (HR 1.92, 95% CI 1.00-3.69) were clearly associated with recurrence; infection with ribotype 027 showed a HR of 1.72 (95% CI 0.88-3.33). During this outbreak of C. difficile in a tertiary care centre, age and a prolonged duration of CDI therapy (which is most likely a marker of underlying disease severity) were the main risk factors for recurrent CDI. This points to host factors as more important predictors for recurrent CDI than strain type or antibiotic use.
A frequent complication of Clostridium difficile infection ( CDI ) is recurrent disease . The aim of this study was to determine whether early recurrence risk was higher after infection with ribotype 027 ( outbreak strain ) compared with infection with endemic strain types of C. difficile . Consecutive patients diagnosed with CDI between May 2013 and March 2014 were included ( outbreak strain , and non - outbreak strains ) . Patients who developed recurrent CDI within 30 days after completion of CDI treatment , were compared with patients without a recurrence . Medical charts were reviewed for demographic and clinical characteristics . General practitioners were contacted to complete data about the occurrence of recurrent CDI , and the use of medication after hospital discharge . In total , 135 patients were at risk for the development of recurrent CDI ; 74 patients were infected by ribotype 027 , and 61 patients by other ribotypes . Thirty - nine patients ( 29 % ) developed recurrent CDI within 30 days after completion of CDI treatment . In multivariable analysis , age ≥70 years ( HR 3.05 , 95 % CI 1.54 - 6.03 ) , and a duration of CDI treatment ≥11 days ( HR 1.92 , 95 % CI 1.00 - 3.69 ) were clearly associated with recurrence ; infection with ribotype 027 showed a HR of 1.72 ( 95 % CI 0.88 - 3.33 ) . During this outbreak of C. difficile in a tertiary care centre , age and a prolonged duration of CDI therapy ( which is most likely a marker of underlying disease severity ) were the main risk factors for recurrent CDI . This points to host factors as more important predictors for recurrent CDI than strain type or antibiotic use .
Which main ribotype of Clostridium difficile is responsible of the recent outbreak?
Which main ribotype of Clostridium difficile is responsible of the recent outbreak ?
Ribotype 027
Ribotype 027