1887
  1. Home
  2. Eurosurveillance
  3. Volume 21, Issue 29, 21/Jul/2016
  4. Article
Surveillance and outbreak report Open Access
Like 0
Download

Abstract

In 2014, 18 hospitals in the Czech Republic participated in a survey of the incidence of infections (CDI) in the country. The mean CDI incidence was 6.1 (standard deviation (SD):7.2) cases per 10,000 patient bed-days and 37.8 cases (SD: 41.4) per 10,000 admissions. The mean CDI testing frequency was 39.5 tests (SD: 25.4) per 10,000 patient bed-days and 255.8 tests (SD: 164.0) per 10,000 admissions. A total of 774 isolates were investigated, of which 225 (29%) belonged to PCR ribotype 176, and 184 isolates (24%) belonged to PCR ribotype 001. Multilocus variable-number tandem repeat analysis (MLVA) revealed 27 clonal complexes formed by 84% (190/225) of PCR ribotype 176 isolates, and 14 clonal complexes formed by 77% (141/184) of PCR ribotype 001 isolates. Clonal clusters of PCR ribotypes 176 and 001 were observed in 11 and 7 hospitals, respectively. Our data demonstrate the spread of two PCR ribotypes within 18 hospitals in the Czech Republic, stressing the importance of standardising CDI testing protocols and implementing mandatory CDI surveillance in the country.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2016.21.29.30296
2016-07-21
2025-07-19
/content/10.2807/1560-7917.ES.2016.21.29.30296
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/21/29/eurosurv-21-30296-7.html?itemId=/content/10.2807/1560-7917.ES.2016.21.29.30296&mimeType=html&fmt=ahah

References

  1. Bauer MP, Notermans DW, van Benthem BH, Brazier JS, Wilcox MH, Rupnik M, et al. ECDIS Study Group. Clostridium difficile infection in Europe: a hospital-based survey. Lancet. 2011;377(9759):63-73.  https://doi.org/10.1016/S0140-6736(10)61266-4  PMID: 21084111 
  2. Davies KA, Longshaw CM, Davis GL, Bouza E, Barbut F, Barna Z, et al. Underdiagnosis of Clostridium difficile across Europe: the European, multicentre, prospective, biannual, point-prevalence study of Clostridium difficile infection in hospitalised patients with diarrhoea (EUCLID). Lancet Infect Dis. 2014;14(12):1208-19.  https://doi.org/10.1016/S1473-3099(14)70991-0  PMID: 25455988 
  3. He M, Miyajima F, Roberts P, Ellison L, Pickard DJ, Martin MJ, et al. Emergence and global spread of epidemic healthcare-associated Clostridium difficile. Nat Genet. 2013;45(1):109-13.  https://doi.org/10.1038/ng.2478  PMID: 23222960 
  4. Kuijper EJ, Coignard B, Tüll PESCMID Study Group for Clostridium difficileEU Member StatesEuropean 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.  https://doi.org/10.1111/j.1469-0691.2006.01580.x  PMID: 16965399 
  5. Rao K, Micic D, Natarajan M, Winters S, Kiel MJ, Walk ST, et al. Clostridium difficile ribotype 027: relationship to age, detectability of toxins A or B in stool with rapid testing, severe infection, and mortality. Clin Infect Dis. 2015;61(2):233-41.  https://doi.org/10.1093/cid/civ254  PMID: 25828993 
  6. Valiente E, Dawson LF, Cairns MD, Stabler RA, Wren BW. Emergence of new PCR ribotypes from the hypervirulent Clostridium difficile 027 lineage. J Med Microbiol. 2012;61(Pt 1):49-56.  https://doi.org/10.1099/jmm.0.036194-0  PMID: 21903827 
  7. Knetsch CW, Hensgens MP, Harmanus C, van der Bijl MW, Savelkoul PH, Kuijper EJ, et al. Genetic markers for Clostridium difficile lineages linked to hypervirulence. Microbiology. 2011;157(Pt 11):3113-23.  https://doi.org/10.1099/mic.0.051953-0  PMID: 21873406 
  8. Krutova M, Matejkova J, Nyc O. C. difficile ribotype 027 or 176? Folia Microbiol (Praha). 2014;59(6):523-6.  https://doi.org/10.1007/s12223-014-0323-5  PMID: 24970104 
  9. Nyč O, Pituch H, Matějková J, Obuch-Woszczatynski P, Kuijper EJ. Clostridium difficile PCR ribotype 176 in the Czech Republic and Poland. Lancet. 2011;377(9775):1407.  https://doi.org/10.1016/S0140-6736(11)60575-8  PMID: 21515161 
  10. Obuch-Woszczatyński P, Lachowicz D, Schneider A, Mól A, Pawłowska J, Ożdżeńska-Milke E, et al. Occurrence of Clostridium difficile PCR-ribotype 027 and it’s closely related PCR-ribotype 176 in hospitals in Poland in 2008-2010. Anaerobe. 2014;28:13-7.  https://doi.org/10.1016/j.anaerobe.2014.04.007  PMID: 24799338 
  11. Pituch H, Obuch-Woszczatyński P, Lachowicz D, Wultańska D, Karpiński P, Młynarczyk G, et al. Hospital-based Clostridium difficile infection surveillance reveals high proportions of PCR ribotypes 027 and 176 in different areas of Poland, 2011 to 2013. Euro Surveill. 2015;20(38):30025.  https://doi.org/10.2807/1560-7917.ES.2015.20.38.30025  PMID: 26536049 
  12. Persson S, Torpdahl M, Olsen KE. New multiplex PCR method for the detection of Clostridium difficile toxin A (tcdA) and toxin B (tcdB) and the binary toxin (cdtA/cdtB) genes applied to a Danish strain collection. Clin Microbiol Infect. 2008;14(11):1057-64.  https://doi.org/10.1111/j.1469-0691.2008.02092.x  PMID: 19040478 
  13. Stubbs SL, Brazier JS, O’Neill GL, Duerden BI. PCR targeted to the 16S-23S rRNA gene intergenic spacer region of Clostridium difficile and construction of a library consisting of 116 different PCR ribotypes. J Clin Microbiol. 1999;37(2):461-3. PMID: 9889244 
  14. Indra A, Huhulescu S, Schneeweis M, Hasenberger P, Kernbichler S, Fiedler A, et al. Characterization of Clostridium difficile isolates using capillary gel electrophoresis-based PCR ribotyping. J Med Microbiol. 2008;57(Pt 11):1377-82.  https://doi.org/10.1099/jmm.0.47714-0  PMID: 18927415 
  15. Fawley WN, Knetsch CW, MacCannell DR, Harmanus C, Du T, Mulvey MR, et al. Development and validation of an internationally-standardized, high-resolution capillary gel-based electrophoresis PCR-ribotyping protocol for Clostridium difficile. PLoS One. 2015;10(2):e0118150.  https://doi.org/10.1371/journal.pone.0118150  PMID: 25679978 
  16. Shannon CE, Claude E. A mathematical theory of communication. The Bell System Technical Journal. 1948;27(3):379-423. doi:10.1002/j.1538-7305.1948.tb01338.x
  17. van den Berg RJ, Schaap I, Templeton KE, Klaassen CH, Kuijper EJ. Typing and subtyping of Clostridium difficile isolates by using multiple-locus variable-number tandem-repeat analysis. J Clin Microbiol. 2007;45(3):1024-8.  https://doi.org/10.1128/JCM.02023-06  PMID: 17166961 
  18. Marsh JW, O’Leary MM, Shutt KA, Pasculle AW, Johnson S, Gerding DN, et al. Multilocus variable-number tandem-repeat analysis for investigation of Clostridium difficile transmission in Hospitals. J Clin Microbiol. 2006;44(7):2558-66.  https://doi.org/10.1128/JCM.02364-05  PMID: 16825380 
  19. Goorhuis A, Legaria MC, van den Berg RJ, Harmanus C, Klaassen CH, Brazier JS, et al. Application of multiple-locus variable-number tandem-repeat analysis to determine clonal spread of toxin A-negative Clostridium difficile in a general hospital in Buenos Aires, Argentina. Clin Microbiol Infect. 2009;15(12):1080-6.  https://doi.org/10.1111/j.1469-0691.2009.02759.x  PMID: 19438624 
  20. Institute of health information and statistics of the Czech Republic (UZIS). [Inpatient care]. Prague: UZIS. [Accessed 26 Jul 2015]. Czech. Available from: http://www.uzis.cz/en/publications/patient-care-2013
  21. National Institute of Public Health (SZU). [Selected infectious diseases in the Czech Republic in the years 2006-2015 - relatively]. Prague: SZU. Czech. [Accessed 26 Jul 2015]. Available from: http://www.szu.cz/publikace/data/vybrane-infekcni-nemoci-v-cr-v-letech-2006-2015-relativne
  22. Debast SB, Bauer MP, Kuijper EJEuropean Society of Clinical Microbiology and Infectious Diseases. European Society of Clinical Microbiology and Infectious Diseases: update of the treatment guidance document for Clostridium difficile infection. Clin Microbiol Infect. 2014;20(Suppl 2):1-26.  https://doi.org/10.1111/1469-0691.12418  PMID: 24118601 
  23. Planche TD, Davies KA, Coen PG, Finney JM, Monahan IM, Morris KA, et al. Differences in outcome according to Clostridium difficile testing method: a prospective multicentre diagnostic validation study of C difficile infection. Lancet Infect Dis. 2013;13(11):936-45.  https://doi.org/10.1016/S1473-3099(13)70200-7  PMID: 24007915 
  24. Krůtová M, Nyč O. [Diagnosis of infections caused by Clostridium difficile in the Czech Republic: availability, possibilities, and interpretation of laboratory results]. Epidemiol Mikrobiol Imunol. 2015;64(2):92-7. Czech. PMID: 26099613 
  25. Krutova M, Nyc O, Kuijper EJ, Geigerova L, Matejkova J, Bergerova T, et al. A case of imported Clostridium difficile PCR-ribotype 027 infection within the Czech Republic which has a high prevalence of C. difficile ribotype 176. Anaerobe. 2014;30:153-5.  https://doi.org/10.1016/j.anaerobe.2014.09.020  PMID: 25300750 
  26. Freeman J, Vernon J, Morris K, Nicholson S, Todhunter S, Longshaw C, et al. Pan-European Longitudinal Surveillance of Antibiotic Resistance among Prevalent Clostridium difficile Ribotypes’ Study Group. Pan-European longitudinal surveillance of antibiotic resistance among prevalent Clostridium difficile ribotypes. Clin Microbiol Infect. 2015;21(3):248.e9-16.  https://doi.org/10.1016/j.cmi.2014.09.017  PMID: 25701178 
  27. Nyc O, Krutova M, Liskova A, Matejkova J, Drabek J, Kuijper EJ. The emergence of Clostridium difficile PCR-ribotype 001 in Slovakia. Eur J Clin Microbiol Infect Dis. 2015;34(8):1701-8.  https://doi.org/10.1007/s10096-015-2407-9  PMID: 25981433 
  28. Arvand M, Vollandt D, Bettge-Weller G, Harmanus C, Kuijper EJClostridium difficile study group Hesse. Increased incidence of Clostridium difficile PCR ribotype 027 in Hesse, Germany, 2011 to 2013. Euro Surveill. 2014;19(10):20732.  https://doi.org/10.2807/1560-7917.ES2014.19.10.20732  PMID: 24650866 
  29. Vanek J, Hill K, Collins J, Berrington A, Perry J, Inns T, et al. Epidemiological survey of Clostridium difficile ribotypes in the North East of England during an 18-month period. J Hosp Infect. 2012;81(3):209-12.  https://doi.org/10.1016/j.jhin.2012.04.017  PMID: 22633277 
  30. Wiuff C, Brown DJ, Mather H, Banks AL, Eastaway A, Coia JE. The epidemiology of Clostridium difficile in Scotland. J Infect. 2011;62(4):271-9.  https://doi.org/10.1016/j.jinf.2011.01.015  PMID: 21300104 
  31. Alcalá L, Martín A, Marín M, Sánchez-Somolinos M, Catalán P, Peláez T, et al. Spanish Clostridium difficile Study Group. The undiagnosed cases of Clostridium difficile infection in a whole nation: where is the problem? Clin Microbiol Infect. 2012;18(7):E204-13.  https://doi.org/10.1111/j.1469-0691.2012.03883.x  PMID: 22563775 
  32. Lachowicz D, Pituch H, Obuch-Woszczatyński P. Antimicrobial susceptibility patterns of Clostridium difficile strains belonging to different polymerase chain reaction ribotypes isolated in Poland in 2012. Anaerobe. 2015;31:37-41.  https://doi.org/10.1016/j.anaerobe.2014.09.004  PMID: 25242196 
  33. Krutova M, Matejkova J, Tkadlec J, Nyc O. Antibiotic profiling of Clostridium difficile ribotype 176--A multidrug resistant relative to C. difficile ribotype 027. Anaerobe. 2015;36:88-90.  https://doi.org/10.1016/j.anaerobe.2015.07.009  PMID: 26256807 
  34. Spigaglia P, Barbanti F, Mastrantonio PEuropean Study Group on Clostridium difficile (ESGCD). Multidrug resistance in European Clostridium difficile clinical isolates. J Antimicrob Chemother. 2011;66(10):2227-34.  https://doi.org/10.1093/jac/dkr292  PMID: 21771851 
  35. European Centre for Disease Prevention and Control (ECDC). European Surveillance of Clostridium difficile infections. Surveillance protocol version 2.2. Stockholm: ECDC; 2015. Available from http:// http://ecdc.europa.eu/en/publications/Publications/European-surveillance-clostridium-difficile.v2FINAL.pdf
Clostridium difficile PCR ribotypes 001 and 176 – the common denominator of C. difficile infection epidemiology in the Czech Republic, 2014
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Marcela+Krutova&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Krutova Marcela</a>, <a href="/search?value1=Jana+Matejkova&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Matejkova Jana</a>, <a href="/search?value1=Ed+J+Kuijper&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kuijper Ed J</a>, <a href="/search?value1=Pavel+Drevinek&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Drevinek Pavel</a>, <a href="/search?value1=Otakar+Nyc&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nyc Otakar</a>, <a href="/search?value1=Czech+Clostridium+difficile+study+group&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Czech Clostridium difficile study group</a></span>. Clostridium difficile PCR ribotypes 001 and 176 – the common denominator of C. difficile infection epidemiology in the Czech Republic, 2014. <a href="/content/ecdc">Euro Surveill.</a> 2016;21(29):pii=30296. <a href="https://doi.org/10.2807/1560-7917.ES.2016.21.29.30296" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2016.21.29.30296</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 27 Jul 2015;&nbsp;&nbsp; <span class="generated">Accepted</span>: 27 Nov 2015 </span> </p>
/content/10.2807/1560-7917.ES.2016.21.29.30296
/content/10.2807/1560-7917.ES.2016.21.29.30296
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error