Spread and Epidemiology of Clostridium difficile Polymerase Chain Reaction Ribotype 027/Toxinotype III in The Netherlands (original) (raw)

Journal Article

,

1

Department of Microbiology, Leiden University Medical Center

,

Leiden

Search for other works by this author on:

,

3

Centre for Infectious Disease Control, National Institute for Public Health and the Environment

,

Bilthoven, The Netherlands

Search for other works by this author on:

,

1

Department of Microbiology, Leiden University Medical Center

,

Leiden

Search for other works by this author on:

,

2

Clinical Epidemiology, Leiden University Medical Center

,

Leiden

Search for other works by this author on:

,

1

Department of Microbiology, Leiden University Medical Center

,

Leiden

Search for other works by this author on:

,

1

Department of Microbiology, Leiden University Medical Center

,

Leiden

Search for other works by this author on:

,

3

Centre for Infectious Disease Control, National Institute for Public Health and the Environment

,

Bilthoven, The Netherlands

Search for other works by this author on:

,

3

Centre for Infectious Disease Control, National Institute for Public Health and the Environment

,

Bilthoven, The Netherlands

Search for other works by this author on:

1

Department of Microbiology, Leiden University Medical Center

,

Leiden

Reprints or correspondence: Dr. Ed J. Kuijper, Dept. of Medical Microbiology, National Reference Laboratory for Clostridium difficile, Leiden University Medical Center, Leiden, PO Box 9600, 2300 RC, The Netherlands (e.j.kuijper@lumc.nl).

Search for other works by this author on:

Published:

15 September 2007

• • Article contents
  • Figures & tables
  • Video
  • Audio
  • Supplementary Data
• Cite

Cite

A. Goorhuis, T. Van der Kooi, N. Vaessen, F. W. Dekker, R. Van den Berg, C. Harmanus, S. van den Hof, D. W. Notermans, E. J. Kuijper, Spread and Epidemiology of Clostridium difficile Polymerase Chain Reaction Ribotype 027/Toxinotype III in The Netherlands, Clinical Infectious Diseases, Volume 45, Issue 6, 15 September 2007, Pages 695–703, https://doi.org/10.1086/520984
Close

Navbar Search Filter Mobile Enter search term Search

Abstract

Background. After reports of emerging outbreaks in Canada and the United States, _Clostridium difficile_—associated disease (CDAD) due to polymerase chain reaction ribotype 027 was detected in 2 medium-to-large hospitals in The Netherlands in 2005.

Methods. National surveillance was initiated to investigate the spread and the epidemiology of CDAD. Microbiologists were asked to send strains recovered from patients with a severe course of CDAD or recovered when an increased incidence of CDAD was noted. A standardized questionnaire was used to collect demographic, clinical, and epidemiological patient data. Strains were characterized by polymerase chain reaction ribotyping, toxinotyping, the presence of toxin genes, and antimicrobial susceptibility.

Results. During the period from February 2005 through November 2006, 1175 stool samples from 863 patients were sent from 50 health care facilities. of these patients, 218 (25.3%) had CDAD due to ribotype 027, and 645 patients (74.7%) had CDAD due to other ribotypes, mainly 001 (17.8%) and 014 (7.2%). Polymerase chain reaction ribotype 027 was more frequently present in general hospitals than in academic hospitals (odds ratio [OR], 4.38; 95% confidence interval [CI], 1.60–12.0). Outbreaks of CDAD were observed in 10 hospitals and in 1 nursing home. Patients infected with ribotype 027 were significantly older (OR, 2.18; 95% CI, 1.43–3.33), and significantly more patients used fluoroquinolones (OR, 2.88; 95% CI, 1.01–8.20), compared with those who were infected with other ribotypes. Clear trends were observed for more severe diarrhea (OR, 1.99; 95% CI, 0.83–4.73), higher attributable mortality (6.3% vs. 1.2%; OR, 3.30; 95% CI, 0.41–26.4), and more recurrences (OR, 1.44; 95% CI, 0.94–2.20).

Conclusions. Ribotype 027 was found in 20 (18.3%) of 109 hospitals in The Netherlands, with a geographic concentration in the western and central parts of the country. The clinical syndrome in patients with CDAD differed on the basis of ribotype. Thus, early recognition of the ribotype has benefits.

© 2007 by the Infectious Diseases Society of America

Topic:

• polymerase chain reaction
• epidemiology
• diarrhea
• canada
• demography
• disease outbreaks
• fluoroquinolones
• genes
• netherlands
• nursing homes
• ribotyping
• toxins
• mortality
• clostridium difficile diarrhea
• antimicrobial susceptibility
• surveillance, medical
• clostridium difficile
• stool specimen

You do not currently have access to this article.

I agree to the terms and conditions. You must accept the terms and conditions.

Submit a comment

Name

Affiliations

Comment title

Comment

You have entered an invalid code

Thank you for submitting a comment on this article. Your comment will be reviewed and published at the journal's discretion. Please check for further notifications by email.

Personal account

• Sign in with email/username & password
• Get email alerts
• Save searches
• Purchase content
• Activate your purchase/trial code
• Add your ORCID iD

Get help with access

Institutional access

Access to content on Oxford Academic is often provided through institutional subscriptions and purchases. If you are a member of an institution with an active account, you may be able to access content in one of the following ways:

IP based access

Typically, access is provided across an institutional network to a range of IP addresses. This authentication occurs automatically, and it is not possible to sign out of an IP authenticated account.

Sign in through your institution

Choose this option to get remote access when outside your institution. Shibboleth/Open Athens technology is used to provide single sign-on between your institution’s website and Oxford Academic.

1. Click Sign in through your institution.
2. Select your institution from the list provided, which will take you to your institution's website to sign in.
3. When on the institution site, please use the credentials provided by your institution. Do not use an Oxford Academic personal account.
4. Following successful sign in, you will be returned to Oxford Academic.

If your institution is not listed or you cannot sign in to your institution’s website, please contact your librarian or administrator.

Sign in with a library card

Enter your library card number to sign in. If you cannot sign in, please contact your librarian.

Society Members

Society member access to a journal is achieved in one of the following ways:

Sign in through society site

Many societies offer single sign-on between the society website and Oxford Academic. If you see ‘Sign in through society site’ in the sign in pane within a journal:

1. Click Sign in through society site.
2. When on the society site, please use the credentials provided by that society. Do not use an Oxford Academic personal account.
3. Following successful sign in, you will be returned to Oxford Academic.

If you do not have a society account or have forgotten your username or password, please contact your society.

Sign in using a personal account

Some societies use Oxford Academic personal accounts to provide access to their members. See below.

Personal account

A personal account can be used to get email alerts, save searches, purchase content, and activate subscriptions.

Some societies use Oxford Academic personal accounts to provide access to their members.

Viewing your signed in accounts

Click the account icon in the top right to:

• View your signed in personal account and access account management features.
• View the institutional accounts that are providing access.

Signed in but can't access content

Oxford Academic is home to a wide variety of products. The institutional subscription may not cover the content that you are trying to access. If you believe you should have access to that content, please contact your librarian.

Institutional account management

For librarians and administrators, your personal account also provides access to institutional account management. Here you will find options to view and activate subscriptions, manage institutional settings and access options, access usage statistics, and more.

Purchase

Short-term Access

To purchase short-term access, please sign in to your personal account above.

Don't already have a personal account? Register

Spread and Epidemiology of Clostridium difficile Polymerase Chain Reaction Ribotype 027/Toxinotype III in The Netherlands - 24 Hours access

EUR €38.00

GBP £33.00

USD $41.00

Rental

This article is also available for rental through DeepDyve.

Citations

Views

Altmetric

Metrics

Total Views 1,487

1,118 Pageviews

369 PDF Downloads

Since 12/1/2016

Citations

124 Web of Science

×

Email alerts

More on this topic

Related articles in PubMed

Citing articles via

• Latest

• Most Read

• Most Cited

More from Oxford Academic