期刊
JOURNAL OF INFECTION
卷 73, 期 2, 页码 115-122出版社
W B SAUNDERS CO LTD
DOI: 10.1016/j.jinf.2016.05.010
关键词
Clostridium difficile infection; Colitis; Ribotype; Proton-pump inhibitors; Antibiotics
资金
- Research Fund for the Control of Infectious Diseases [CU-09-03-04]
- Food and Health Bureau of the Hong Kong Special Administrative Region Government
- Departmental Research Fund, Faculty of Medicine, The Chinese University of Hong Kong
- Croucher Foundation
Objectives: We aim to study the disease burden, risk factors and severity of Clostridium difficile infection (CDI) in Hong Kong. Methods: We conducted a prospective, caseecontrol study in three acute-care hospitals in Hong Kong. Adult inpatients who developed CDI diarrhoea confirmed by PCR (n = 139) were compared with the non-CDI controls (n = 114). Ribotyping of isolates and antimicrobial susceptibility testing were performed. Results: The estimated crude annual incidence of CDI was 23-33/100,000 population, and 133-207/100,000 population among those aged >= 65 years. The mean age of CDI patients was 71.5. Nursing home care, recent hospitalization, antibiotics exposure (adjusted OR 3.0, 95% CI 1.3-7.1) and proton-pump inhibitors use (adjusted OR 2.2, 95% CI 1.2-3.9) were risk factors. Severe CDI occurred in 41.7%. Overall mortality was 16.5% (among severe CDI, 26.5%). The commonest ribotypes were 002 (22.8%), 014 (14.1%), 012 and 046; ribotype 027 was absent. Ribotype 002 was associated with fluoroquinolone resistance and higher mortality (47.6% vs. 12.7%; adjusted HR 2.8, 95% CI 1.1-7.0). Conclusions: Our findings show high morbidity and mortality of CDI in the older adults, and identify ribotype 002 as a possible virulent strain causing serious infections in this cohort. (C) 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
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