The association of a reduced susceptibility to moxifloxacin in causative Clostridium (Clostridioides) difficile strain with the clinical outcome of patients
Abstract Objectives To investigate the relationship between Clostridium (Clostridioides) difficile strain characteristics and C. difficile infection (CDI) outcome. Methods Between October and December 2017, 16 hospitals collected epidemiological data according to the European Centre for Disease Prev...
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | Antimicrobial Resistance and Infection Control |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13756-020-00765-y |
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| author | Marcela Krutova Vaclav Capek Elka Nycova Sabina Vojackova Magda Balejova Lenka Geigerova Renata Tejkalova Lenka Havlinova Iva Vagnerova Pavel Cermak Lenka Ryskova Petr Jezek Dana Zamazalova Denisa Vesela Alice Kucharova Dana Nemcova Martina Curdova Otakar Nyc Pavel Drevinek |
| author_facet | Marcela Krutova Vaclav Capek Elka Nycova Sabina Vojackova Magda Balejova Lenka Geigerova Renata Tejkalova Lenka Havlinova Iva Vagnerova Pavel Cermak Lenka Ryskova Petr Jezek Dana Zamazalova Denisa Vesela Alice Kucharova Dana Nemcova Martina Curdova Otakar Nyc Pavel Drevinek |
| author_sort | Marcela Krutova |
| collection | DOAJ |
| description | Abstract Objectives To investigate the relationship between Clostridium (Clostridioides) difficile strain characteristics and C. difficile infection (CDI) outcome. Methods Between October and December 2017, 16 hospitals collected epidemiological data according to the European Centre for Disease Prevention and Control (ECDC) surveillance protocol for CDI. C. difficile isolates were characterized by ribotyping, toxin genes detection and antibiotic susceptibility testing to metronidazole, vancomycin and moxifloxacin. Results The overall mean CDI incidence density was 4.5 [95% CI 3.6–5.3] cases per 10,000 patient-days. From the 433 CDI cases, 330 (76.2%) were healthcare-associated, 52 (12.0%) cases were community-associated or of unknown origin and 51 (11.8%) CDI cases recurrent; a complicated course of CDI was reported in 65 cases (15.0%). Eighty-eight (20.3%) of patients died and 59 of them within 30 days after the CDI diagnosis. From the 379 C. difficile isolates, the most prevalent PCR ribotypes were 001 (n = 127, 33.5%) and 176 (n = 44, 11.6%). A total of 186 (49.1%) isolates showed a reduced susceptibility to moxifloxacin (> 4 mg/L) and 96.4% of them had Thr82Ile in the GyrA. Nineteen isolates revealed reduced susceptibility to metronidazole and two isolates to vancomycin (> 2 mg/L). A fatal outcome was associated with a reduced susceptibility to moxifloxacin, the advanced age of the patients and a complicated course of CDI (p<0.05). No association between ribotype, binary toxin and a reduced susceptibility to moxifloxacin and complicated course or recurrent CDI was found. Conclusions A reduced susceptibility to moxifloxacin, in causative C. difficile strains was associated with fatal outcome of the patients, therefore it is an important marker in surveillance of CDI. |
| first_indexed | 2024-12-20T13:51:30Z |
| format | Article |
| id | doaj.art-bfccef46c1c44ebe97af5cf581c33e3c |
| institution | Directory Open Access Journal |
| issn | 2047-2994 |
| language | English |
| last_indexed | 2024-12-20T13:51:30Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Antimicrobial Resistance and Infection Control |
| spelling | doaj.art-bfccef46c1c44ebe97af5cf581c33e3c2022-12-21T19:38:31ZengBMCAntimicrobial Resistance and Infection Control2047-29942020-06-01911710.1186/s13756-020-00765-yThe association of a reduced susceptibility to moxifloxacin in causative Clostridium (Clostridioides) difficile strain with the clinical outcome of patientsMarcela Krutova0Vaclav Capek1Elka Nycova2Sabina Vojackova3Magda Balejova4Lenka Geigerova5Renata Tejkalova6Lenka Havlinova7Iva Vagnerova8Pavel Cermak9Lenka Ryskova10Petr Jezek11Dana Zamazalova12Denisa Vesela13Alice Kucharova14Dana Nemcova15Martina Curdova16Otakar Nyc17Pavel Drevinek18Department of Medical Microbiology, Charles UniversityBioinformatics centre, 2nd Faculty of Medicine, Charles UniversityDepartment of Medical Microbiology, Hospital BulovkaDepartment of Medical Microbiology, University Hospital BrnoDepartment of Medical Microbiology, Hospital Ceske BudejoviceDepartment of Medical Microbiology, Faculty of Medicine, Charles University and University Hospital PlzenDepartment of Medical Microbiology, Faculty of Medicine, Masaryk University and St. Anne’s University HospitalDepartment of Medical Microbiology and Immunology, Hospital LiberecDepartment of Microbiology, Faculty of Medicine and Dentistry, Palacky University HospitalDepartment of Medical Microbiology, Thomayer’s HospitalDepartment of Clinical Microbiology, University Hospital Hradec KraloveDepartment of Clinical Microbiology and Parasitology, Hospital PribramDepartment of Clinical Microbiology, Hospital Nove Mesto na MoraveDepartment of Medical Microbiology, Hospital Jindrichuv HradecDepartment of Medical Microbiology, Hospital TaborDepartment of Clinical Microbiology, Institute for Clinical and Experimental MedicineDepartment of Clinical Microbiology, Military University HospitalDepartment of Medical Microbiology, Charles UniversityDepartment of Medical Microbiology, Charles UniversityAbstract Objectives To investigate the relationship between Clostridium (Clostridioides) difficile strain characteristics and C. difficile infection (CDI) outcome. Methods Between October and December 2017, 16 hospitals collected epidemiological data according to the European Centre for Disease Prevention and Control (ECDC) surveillance protocol for CDI. C. difficile isolates were characterized by ribotyping, toxin genes detection and antibiotic susceptibility testing to metronidazole, vancomycin and moxifloxacin. Results The overall mean CDI incidence density was 4.5 [95% CI 3.6–5.3] cases per 10,000 patient-days. From the 433 CDI cases, 330 (76.2%) were healthcare-associated, 52 (12.0%) cases were community-associated or of unknown origin and 51 (11.8%) CDI cases recurrent; a complicated course of CDI was reported in 65 cases (15.0%). Eighty-eight (20.3%) of patients died and 59 of them within 30 days after the CDI diagnosis. From the 379 C. difficile isolates, the most prevalent PCR ribotypes were 001 (n = 127, 33.5%) and 176 (n = 44, 11.6%). A total of 186 (49.1%) isolates showed a reduced susceptibility to moxifloxacin (> 4 mg/L) and 96.4% of them had Thr82Ile in the GyrA. Nineteen isolates revealed reduced susceptibility to metronidazole and two isolates to vancomycin (> 2 mg/L). A fatal outcome was associated with a reduced susceptibility to moxifloxacin, the advanced age of the patients and a complicated course of CDI (p<0.05). No association between ribotype, binary toxin and a reduced susceptibility to moxifloxacin and complicated course or recurrent CDI was found. Conclusions A reduced susceptibility to moxifloxacin, in causative C. difficile strains was associated with fatal outcome of the patients, therefore it is an important marker in surveillance of CDI.http://link.springer.com/article/10.1186/s13756-020-00765-yClostridium difficile infectionClostridioides difficile infectionCzech RepublicPCR ribotype 001PCR ribotype 176Moxifloxacin |
| spellingShingle | Marcela Krutova Vaclav Capek Elka Nycova Sabina Vojackova Magda Balejova Lenka Geigerova Renata Tejkalova Lenka Havlinova Iva Vagnerova Pavel Cermak Lenka Ryskova Petr Jezek Dana Zamazalova Denisa Vesela Alice Kucharova Dana Nemcova Martina Curdova Otakar Nyc Pavel Drevinek The association of a reduced susceptibility to moxifloxacin in causative Clostridium (Clostridioides) difficile strain with the clinical outcome of patients Antimicrobial Resistance and Infection Control Clostridium difficile infection Clostridioides difficile infection Czech Republic PCR ribotype 001 PCR ribotype 176 Moxifloxacin |
| title | The association of a reduced susceptibility to moxifloxacin in causative Clostridium (Clostridioides) difficile strain with the clinical outcome of patients |
| title_full | The association of a reduced susceptibility to moxifloxacin in causative Clostridium (Clostridioides) difficile strain with the clinical outcome of patients |
| title_fullStr | The association of a reduced susceptibility to moxifloxacin in causative Clostridium (Clostridioides) difficile strain with the clinical outcome of patients |
| title_full_unstemmed | The association of a reduced susceptibility to moxifloxacin in causative Clostridium (Clostridioides) difficile strain with the clinical outcome of patients |
| title_short | The association of a reduced susceptibility to moxifloxacin in causative Clostridium (Clostridioides) difficile strain with the clinical outcome of patients |
| title_sort | association of a reduced susceptibility to moxifloxacin in causative clostridium clostridioides difficile strain with the clinical outcome of patients |
| topic | Clostridium difficile infection Clostridioides difficile infection Czech Republic PCR ribotype 001 PCR ribotype 176 Moxifloxacin |
| url | http://link.springer.com/article/10.1186/s13756-020-00765-y |
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