Characteristics and incidence of Clostridium difficile-associated disease in The Netherlands, 2005
Characteristics and incidence of Clostridium difficile-associated disease in The Netherlands, 2005
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DOI：
10.1111/j.1469-0691.2007.01793.x
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发表时间：
2007-11-01
影响因子：
14.2
通讯作者：
Kuijper, E. J.
中科院分区：
文献类型：
--
作者：
Paltansing, S.;van den Berg, R. J.;Kuijper, E. J.
在2005年的2个月期间，有13个实验室参加了荷兰17家医院的艰难梭菌相关疾病（CDAD）的监视研究。根据医院，CDAD的中值发生率为16/10 000例患者入院（2.2/10 000例患者周期），根据医院的说法从1到46/10 000例患者入院。总共有81例CDAD患者； 49例（61％）患者患有医院CDAD，当已经患有腹泻时，有29名（36％）患者被送进医院。两次（2％）死亡归因于CDAD；这两名患者都被严重的社区发作CDAD录取，年龄较高80岁。在64种毒素分离株中，有10名（16％）属于PCR核糖型027和10（16％）的PCR核糖型014。在未识别的爆发期间，一名医院的十名患者发现了027型。 64种分离株的毒素分型揭示了六种不同的毒素类型的存在，有41（64％）的毒素型0，弓形虫III的10（16％）分离株，和94（14％）的弓形虫分离株，toxinot型V.的64个毒素分离株，7（11％（11％）），是一个39％的39-9-9-9-9-9-9％（39％）。 18 bp的删除，一个（1％）的缺失为c。 44 bp。 Genes for binary toxin were present in 21 (33%) of the 64 toxinogenic isolates, mainly associated with toxinotypes III and V. It was concluded that the median CDAD incidence rate of 16/10 000 patient admissions in The Netherlands is considerably lower than that in Canada and the USA, and that the emerging type 027 can spread unnoticed.具有社区发作的CDAD病例的高比例（36％）对CDAD流行病学的未来研究具有重要意义。
During a 2-month period in 2005, 13 laboratories participated in a surveillance study of Clostridium difficile-associated disease (CDAD) in 17 hospitals in The Netherlands. The median incidence rate of CDAD was 16/10 000 patient admissions (2.2/10 000 patient-days) and varied from 1 to 46/10 000 patient admissions according to hospital. In total, 81 patients with CDAD were reported; 49 (61%) patients had nosocomial CDAD, and 29 (36%) patients were admitted to hospital when already suffering from diarrhoea. Two (2%) deaths were attributable to CDAD; both of these patients were admitted with severe community-onset CDAD and were aged > 80 years. Among 64 toxinogenic isolates, ten (16%) belonged to PCR ribotype 027 and ten (16%) to PCR ribotype 014. Type 027 was identified in ten patients from one hospital during an unrecognised outbreak. Toxinotyping of the 64 isolates revealed the presence of six different toxinogenic types, with 41 (64%) isolates of toxinotype 0, ten (16%) isolates of toxinotype III, and nine (14%) isolates of toxinotype V. Of the 64 toxinogenic isolates, seven (11%) had a 39-bp deletion in the tcdC gene, 11 (17%) had an 18-bp deletion, and one (1%) had a deletion of c. 44 bp. Genes for binary toxin were present in 21 (33%) of the 64 toxinogenic isolates, mainly associated with toxinotypes III and V. It was concluded that the median CDAD incidence rate of 16/10 000 patient admissions in The Netherlands is considerably lower than that in Canada and the USA, and that the emerging type 027 can spread unnoticed. The high proportion (36%) of CDAD cases with a community onset has important implications for future studies of the epidemiology of CDAD.