RESUMEN
Between 2000 and 2009, the total number of patients with Clostridium difficile infections increased considerably in Southeastern Germany. A clear seasonality was observed with a higher number of affected patients occurring in the winter months (January-March). Moxifloxacin and erythromycin-resistant C. difficile PCR ribotypes 001 (72%) and 027 (4·6%) were the most commonly isolated strains.
Asunto(s)
Clostridioides difficile/aislamiento & purificación , Infecciones por Clostridium/epidemiología , Estaciones del Año , Antibacterianos/farmacología , Compuestos Aza/farmacología , Análisis por Conglomerados , Farmacorresistencia Bacteriana , Eritromicina/farmacología , Fluoroquinolonas , Genotipo , Alemania/epidemiología , Humanos , Moxifloxacino , Quinolinas/farmacología , RibotipificaciónRESUMEN
To study if antibiotic treatment of outpatients had triggered Clostridium difficile infections (CDI), prescription numbers were compared with CDI-affected patient numbers. A strong correlation was observed for ciprofloxacin (R=0.917), suggesting that increased use of ciprofloxacin by outpatients contributed to increased numbers of CDI. These findings deserve further investigation as they may have an impact on future decisions regarding antibiotic prescribing.
Asunto(s)
Antiinfecciosos , Ciprofloxacina , Infecciones por Clostridium/inducido químicamente , Pacientes Ambulatorios , Antiinfecciosos/uso terapéutico , Ciprofloxacina/uso terapéutico , Clostridioides difficile/aislamiento & purificación , Infecciones por Clostridium/epidemiología , Contraindicaciones , Alemania/epidemiología , Humanos , Quinolonas/uso terapéuticoRESUMEN
In recent years, Clostridium difficile infection (CDI) has emerged as an increasing problem, both in in- and outpatients. In a rural region of southern Germany, the annual number of C. difficile toxin (Tcd)-positive patients has increased from 95 to 796 in the period from 2000 to 2007. Simultaneously, the proportion of positive tests among all Tcd examinations has risen from 7.0% to 12.8%, indicating that the higher number of affected patients was not solely due to an increase in the number of assays. Elevated numbers of CDI have recently been associated with outbreaks of the ribotype 027 strain, particularly in North America. This strain has also been isolated in Europe, including in Germany. Ribotyping and PCR testing for binary toxin genes of C. difficile strains isolated from in- and outpatients demonstrate a predominance (59%) of C. difficile ribotype 001, which exhibits antibiotic resistance to erythromycin, ciprofloxacin, and moxifloxacin, but lacks binary toxin genes. In summary, in our region of Germany, the number of patients affected by CDI has increased, probably due to spread of C. difficile ribotype 001.