Outbreak of Clostridium difficile infection in a long-term care facility: association with gatifloxacin use - PubMed (original) (raw)
. 2004 Mar 1;38(5):640-5.
doi: 10.1086/381551. Epub 2004 Feb 11.
Affiliations
- PMID: 14986246
- DOI: 10.1086/381551
Outbreak of Clostridium difficile infection in a long-term care facility: association with gatifloxacin use
Robert Gaynes et al. Clin Infect Dis. 2004.
Abstract
To determine the cause of an increase in the rate of Clostridium difficile-associated diarrhea (CDAD) in a long-term care facility (LTCF), we analyzed CDAD cases among LTCF patients from October 2001 through June 2002. CDAD cases were identified from review of all enzyme immunoassays positive for C. difficile toxin A. The increase coincided with a formulary change from levofloxacin to gatifloxacin. We performed a case-control study in which we randomly selected control subjects from 612 LTCF admissions during this period. Although we examined a variety of risk factors, logistic regression analysis only demonstrated associations between CDAD and use of clindamycin (P=.005) and gatifloxacin, the latter being associated with an increasing risk of CDAD with increasing duration of gatifloxacin therapy (P<.0001). We concluded that an outbreak of CDAD in an LTCF was associated with a formulary change from levofloxacin to gatifloxacin. The rate of CDAD in the LTCF decreased after a change back to levofloxacin.
Comment in
- Clindamycin, cephalosporins, fluoroquinolones, and Clostridium difficile-associated diarrhea: this is an antimicrobial resistance problem.
Gerding DN. Gerding DN. Clin Infect Dis. 2004 Mar 1;38(5):646-8. doi: 10.1086/382084. Epub 2004 Feb 11. Clin Infect Dis. 2004. PMID: 14986247 No abstract available. - The incidence of Clostridium difficile-associated and non-C. difficile-associated diarrhea after use of gatifloxacin and levofloxacin in an acute-care facility.
Khurana A, Vinayek N, Recco RA, Go ES, Zaman MM. Khurana A, et al. Clin Infect Dis. 2004 Aug 15;39(4):602-3. doi: 10.1086/422525. Clin Infect Dis. 2004. PMID: 15356836 No abstract available. - Outbreak of Clostridium difficile infection and gatifloxacin use in a long-term care facility.
Mohr J. Mohr J. Clin Infect Dis. 2004 Sep 15;39(6):875-6; author reply 876-7. doi: 10.1086/423277. Clin Infect Dis. 2004. PMID: 15472828 No abstract available.
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