Health care-associated clostridium difficile infection in Canada: Patient age and infecting strain type are highly predictive of severe outcome and mortality

Clinical Infectious Diseases

Volumn 50, Issue 2, 2010, Pages 194-201

  Miller, Mark ^a   Gravel, Denise ^c   Mulvey, Michael ^g   Taylor, Geoffrey ^h   Boyd, David ^g   Simor, Andrew ^d   Gardam, Michael ^e   McGeer, Allison ^f   Hutchinson, James ⁱ   Moore, Dorothy ^b   Kelly, Sharon ^f  

^a MCGILL UNIVERSITY   (Canada)

^b MONTREAL CHILDREN S HOSPITAL   (Canada)

^c PUBLIC HEALTH AGENCY OF CANADA   (Canada)

^d SUNNYBROOK RESEARCH INSTITUTE   (Canada)

^e UNIVERSITY HEALTH NETWORK   (Canada)

^f MOUNT SINAI HOSPITAL   (Canada)

^g PUBLIC HEALTH AGENCY OF CANADA   (Canada)

^h UNIVERSITY OF ALBERTA HOSPITAL   (Canada)

ⁱ Health Sciences Centre St John's   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

CEFAZOLIN; CEFOTAXIME; CEFTRIAXONE; CEFUROXIME; CIPROFLOXACIN; CLINDAMYCIN; GATIFLOXACIN; LEVOFLOXACIN; METRONIDAZOLE; MOXIFLOXACIN; TEICOPLANIN; VANCOMYCIN;

ADULT; AGED; ANTIBIOTIC SENSITIVITY; ARTICLE; BACTERIAL STRAIN; BACTERIUM ISOLATE; CANADA; CLOSTRIDIUM DIFFICILE; CLOSTRIDIUM DIFFICILE INFECTION; COLON RESECTION; DISEASE SEVERITY; GROUPS BY AGE; HOSPITAL INFECTION; HOSPITAL PATIENT; HUMAN; INCIDENCE; INTENSIVE CARE UNIT; MAJOR CLINICAL STUDY; MORTALITY; PRIORITY JOURNAL; TREATMENT OUTCOME;

ADOLESCENT; ADULT; AGE FACTORS; AGED; AGED, 80 AND OVER; CANADA; CLOSTRIDIUM DIFFICILE; CLOSTRIDIUM INFECTIONS; CROSS INFECTION; HUMANS; MIDDLE AGED; PROGNOSIS; PROSPECTIVE STUDIES; SEVERITY OF ILLNESS INDEX; YOUNG ADULT;

EID: 73649139991     PISSN: 10584838     EISSN: None     Source Type: Journal    
DOI: 10.1086/649213     Document Type: Article

References (33)

1. Muto CA, Pokrywka M, Shutt K, et al. A large outbreak of Clostridium difficile-associated disease with an unexpected proportion of deaths and colectomies at a teaching hospital following increased fluoroquinolone use. Infect Control Hosp Epidemiol 2005; 26: 273-280.
2. Loo VG, Poirier L, Miller MA, et al. A predominantly clonal multiinstitutional outbreak of Clostridium difficile-associated diarrhea with high morbidity and mortality. New Engl J Med 2005; 353: 2442-2449.
3. McDonald LC, Killgore GE, Thompson A, et al. An epidemic, toxin gene-variant strain of Clostridium difficile, New England Journal of Medicine 2005; 353: 2433-2441.
4. Hubert B, Loo VG, Bourgault AM, et al. A portrait of the geographic dissemination of the Clostridium difficile North American pulsed-field type 1 strain and the epidemiology of C. difficile-associated disease in Quebec. Clin Infect Dis 2007; 44: 238-244.
5. Pepin J, Valiquette L, Alary ME, et al. Clostridium difficile-associated diarrhea in a region of Quebec from 1991 to 2003: a changing pattern of disease severity. CMAJ 2004; 171: 466-472.
6. Kuijper EJ, Coignard B, Tull P; ESCMID Study Group for Clostridium difficile; EU Member States, European Centre for Disease Prevention and Control. Emergence of Clostridium difficile-associated disease in North America and Europe. Clin Microbiol Infect 2006; 12(Suppl 6): 2-18.
7. McDonald LC. Owings M. Jernigan DB. Clostridium difficile infection in patients discharged from US short-stay hospitals, 1996-2003. Emerg Infect Dis 2006; 12: 409-415.
8. MacCannell DR, Louie TJ, Gregson DB, et al. Molecular analysis of Clostridium difficile PCR ribotype 027 isolates from Eastern and Western Canada. J Clin Microbiol 2006; 44: 2147-2152.
9. Kuijper EJ, Barbut F, Brazier JS, et al. Update of Clostridium difficile infection due to PCR ribotype 027 in Europe, 2008. Euro Surveill 2008; 13(31):pii. 18942.
10. Hyland M, Ofner-Agostini M, Miller M, et al. Nosocomial C difficile-associated disease in Canada: results of the Canadian Nosocomial Infection Surveillance Program 1997 N-CDAD prevalence Surveillance Project. Can J Infect Dis 2001; 12: 81-88.
11. Miller M, Hyland M, Ofner-Agostini M. Morbidity, mortality and health care burden of nosocomial Clostridium difficile diarrhea in Canadian healthcare facilities. Infect Control Hosp Epidemiol 2002; 23: 137-140.
12. Labbé AC, Poirier L, MacCannell D, Louie T, Savoie M, Béliveau C, Laverdière M, Pépin J. Clostridium difficile Infections in a Canadian Tertiary Care Hospital before and during a Regional Epidemic Associated with the BI/NAP1/027 Strain. Antimicrob Agents Chemother 2008; 52: 3180-3187
13. Morgan OW, Rodrigues B, Elston T, et al. Clinical severity of Clostridium difficile PCR ribotype 027: a case-case study. PLoS ONE 2008; 3(3): e1812. doi:10.1371/journal.pone.0001812.
14. Dubberke ER, Butler AM, Reske KA, et al. Attributable outcomes of endemic Clostridium difficile-associated disease in nonsurgical patients. Emerg Infect Dis 2008; 14(7): 1031-1038.
15. Cloud J, Noddin L, Pressman A, Hu M, Kelly C. Clostridium difficile strain NAP-1 is not associated with severe disease in a nonepidemic setting. Clin Gastroenterol Hepatol 2009; 7: 868-873.
16. Gravel D, Miller M, Simor A, et al; the Canadian Nosocomial Infection Surveillance Program. Health care-associated Clostridium difficile infection in adults admitted to acute care hospitals in Canada: a Canadian Nosocomial Infection Surveillance Program study. Clin Infect Dis 2009; 48: 568-576.
17. Suh KN, Gravel D, Miller M, et al. Clostridium difficile associated diarrhea in children admitted to acute care hospitals participating in the Canadian Nosocomial Infections Surveillance Program (CNISP), 2004-2005 [abstract 306]. In: Program and abstract of the Annual meeting of the Society for Healthcare Epidemiology of America (SHEA), Orlando, Florida, April 2008.
18. Clabots CR, Gerding SJ, Olson MM, Peterson LR, Gerding DN. De tection of asymptomatic Clostridium difficile carriage by an alcohol shock procedure. J Clin Microbiol 1989; 27: 2386-2387.
19. Killgore G, Thompson A, Johnson S, et al. Comparison of seven techniques for typing international epidemic strains of Clostridium difficile: restriction endonuclease analysis, pulsed-field gel electrophoresis, PCR-ribotyping, multilocus sequence typing, multilocus variable-number tandem-repeat analysis, amplified fragment length polymorphism, and surface layer protein A gene sequence typing. J Clin Microbiol 2008; 46: 431-437.
20. Clinical and Laboratory Standards Institute. Methods for antimicrobial susceptibility testing of anaerobic bacteria. 7th ed. Wayne, PA: National Committee for Clinical and Laboratory Standards, 2007. Approved standard document M11-A7.
21. Barbut F, Mastrantonio P, Delmee M, Brazier J, Kuijper E, Poxton I; European Study Group on Clostridium difficile (ESGCD). Prospective study of Clostridium difficile infections in Europe with phenotypic and genotypic characterization of the isolates. Clin Microbiol Infect 2007; 13: 1048-1057.
22. Goorhuis A, Van der Kooi T, Vaessen N, et al. Spread and epidemiology of Clostridium difficile polymerase chain reaction ribotype 027/toxinotype III in The Netherlands. Clin Infect Dis 2007; 45: 695-703.
23. Morgan OW, Rodrigues B, Elston T, et al. Clinical severity of Clostridium difficile PCR ribotype 027: a case-case study. PLoS ONE 3: e1812. doi:10.1371/journal.pone.0001812.
24. Relier ME, Lema CA, Perl TM, et al. Yield of stool culture with isolate toxin testing versus a two-step algorithm including stool toxin testing for detection of toxigenic Clostridium difficile. J Clin Microbiol 2007; 45: 3601-3605.
25. Fawley WN, Freeman J, Smith C, et al. Use of highly discriminatory fingerprinting to analyze clusters of Clostridium difficile infection cases due to epidemic ribotype 027 strains. J Clin Microbiol 2008; 46: 954-960.
26. Killgore G, Thompson A, Johnson S, et al. Comparison of seven techniques for typing international epidemic strains of Clostridium difficile: restriction endonuclease analysis, pulsed-field gel electrophoresis, PCR-ribotyping, multilocus sequence typing, multilocus variable-number tandem-repeat analysis, amplified fragment length polymorphism and surface layer protein A gene sequence typing. J Clin Microbiol 2008; 46: 431-437.
27. Bourgault AM, Lamothe F, Loo VG, Poirier L; CDAD-CSI Study Group. In vitro susceptibility of Clostridium difficile clinical isolates from a multi-institutional outbreak in Southern Quebec, Canada. Antimicrob Agents Chemother 2006; 50: 3473-3475.
28. McDonald LC, Coignard B, Dubberke E, Song X, Horan T, Kutty PK. Recommendations for surveillance of Clostridium difficile-associated disease. Infect Control Hosp Epidemiol 2007; 28: 140-145.
29. Miller M, Gravel D, Mulvey M, et al. Ongoing epidemiology of healthcare-associated C. difficile in Canada: evidence for further spread of NAP1/027 and coincident increased mortality (abstract 350). In: Program and abstracts of the Annual Meeting of the Society for Healthcare Epidemiology of America (SHEA), San Dieago, CA, March 2009.
30. Warny M, Pepin J, Fang A, et al. Toxin production by an emerging strain of Clostridium difficile associated with outbreaks of severe disease in North America and Europe. Lancet 2005; 366: 1079-1084.
31. Terhes G, Urban E, Soki J, Hamid KA, Nagy E. Community-acquired Clostridium difficile diarrhea caused by binary toxin, toxin A and toxin B gene positive isolates in Hungary. J Clin Microbiol 2004; 42: 4316-4318.
32. Lemee L, Dhalluin A, Testelin S, et al. Multiplex PCR targeting tpi (triose phosphate isomerase), tcdA (toxin A), and tcdB genes for toxigenic culture of Clostridium difficile. J Clin Microbiol 2004; 42: 5710-5714.
33. Spigaglia P, Mastrantonio P. Comparative analysis of Clostridium difficile clinical isolates belonging to different genetic lineages and time periods. J Med Microbiol 2004; 53: 1129-1136.