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Cefoperazone-treated Mouse Model of Clinically-relevant Clostridium difficile Strain R20291
Published on: December 10, 2016
Clostridium difficile infection caused by the epidemic BI/NAP1/027 strain.
Jennifer R O'Connor1, Stuart Johnson, Dale N Gerding
1Research Service, Edward Hines Jr VA Hospital, Hines, Illinois 60141, USA.
Gastroenterology
|May 22, 2009
Summary
A specific Clostridium difficile strain (BI/NAP1/027) is causing more severe hospital infections due to increased toxin production and antibiotic resistance. Controlling outbreaks requires strict hygiene and careful antibiotic use.
Area of Science:
- Infectious Diseases
- Microbiology
- Epidemiology
Background:
- Clostridium difficile infection (CDI) rates and severity have risen since 2000.
- An epidemic strain, designated BI/NAP1/027, is associated with increased toxin production and fluoroquinolone resistance.
Purpose of the Study:
- Investigate the factors contributing to the geographic spread and severity of CDI caused by the BI/NAP1/027 strain.
- Identify key risk factors and effective treatment and control strategies for BI/NAP1/027 infections.
Main Methods:
- Genomic analysis to characterize the BI/NAP1/027 strain.
- Epidemiological studies to identify risk factors and mortality rates.
- Clinical data review for treatment efficacy.
Main Results:
- The BI/NAP1/027 strain exhibits enhanced toxin A and B production, possibly due to a tcdC gene deletion.
- This strain shows high-level resistance to fluoroquinolones, facilitating its spread.
- Infections are most common in elderly hospitalized patients, with a >5% attributable 30-day mortality.
Conclusions:
- The BI/NAP1/027 strain poses a significant threat due to its virulence and resistance.
- Risk factors include advanced age, hospitalization, and exposure to certain antibiotics.
- Effective control involves barrier precautions, environmental cleaning, and antimicrobial stewardship; vancomycin is preferred for severe CDI.
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