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A pilot study in Serbia by European Clostridium difficile Infection Surveillance Network
Milica Jovanović1, Sofie M van Dorp2, Mitra Drakulović3
1Department of Microbiology,Clinical Center of Serbia, Belgrade,Serbia.
Acta Microbiologica Et Immunologica Hungarica
|December 10, 2019
Summary
Clostridium difficile infections (CDI) are common in Serbia. A pilot study found high rates of the hypervirulent ribotype 027, highlighting the need for national CDI surveillance.
Area of Science:
- Infectious Diseases
- Epidemiology
- Microbiology
Background:
- Clostridium (Clostridioides) difficile infections (CDIs) represent a significant healthcare-associated infection burden in Serbia.
- Standardized surveillance and laboratory capacity are crucial for effective CDI management.
Purpose of the Study:
- To assess the incidence and epidemiology of CDI in Serbia through a pilot surveillance study.
- To characterize Clostridium difficile isolates, including ribotype and antimicrobial susceptibility.
- To establish a foundation for a national CDI surveillance program.
Main Methods:
- A 3-month pilot study conducted in 2013 involving two clinics in Belgrade and one hospital in Užice.
- Inclusion of all diagnosed CDI patients during the study period.
- Laboratory analysis including Clostridium difficile ribotyping and antimicrobial susceptibility testing.
Main Results:
- CDI incidence rates varied by facility, with the highest at 19.0 per 10,000 patient-days.
- Clostridium difficile ribotype 027 was predominant (78.9%) among isolates.
- Low MICs for metronidazole and vancomycin, but high resistance to moxifloxacin observed in ribotype 027 strains.
Conclusions:
- The pilot study demonstrated the feasibility and importance of national CDI surveillance in Serbia.
- The prevalence of Clostridium difficile ribotype 027 warrants attention due to its association with severe infections.
- Findings support the need for enhanced laboratory capacity and standardized surveillance protocols for CDI.