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Hospital-acquired Clostridium difficile infection in Mainland China: A seven-year (2009–2016) retrospective study in a large university hospital

Clostridium difficile infection (CDI) is associated with risk for severe disease and high mortality. Little is known about the extent of hospital-acquired CDI in Mainland China. In this study, we aimed to investigate the annual CDI incidence, bacterial genotypes, risk factors for severe CDI and surv...

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Autores principales: Xu, Qiaomai, Chen, Yunbo, Gu, Silan, Lv, Tao, Zheng, Beiwen, Shen, Ping, Quan, Jiazheng, Fang, Yunhui, Li, Lanjuan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5575102/
https://www.ncbi.nlm.nih.gov/pubmed/28852010
http://dx.doi.org/10.1038/s41598-017-09961-0
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author Xu, Qiaomai
Chen, Yunbo
Gu, Silan
Lv, Tao
Zheng, Beiwen
Shen, Ping
Quan, Jiazheng
Fang, Yunhui
Li, Lanjuan
author_facet Xu, Qiaomai
Chen, Yunbo
Gu, Silan
Lv, Tao
Zheng, Beiwen
Shen, Ping
Quan, Jiazheng
Fang, Yunhui
Li, Lanjuan
author_sort Xu, Qiaomai
collection PubMed
description Clostridium difficile infection (CDI) is associated with risk for severe disease and high mortality. Little is known about the extent of hospital-acquired CDI in Mainland China. In this study, we aimed to investigate the annual CDI incidence, bacterial genotypes, risk factors for severe CDI and survival over a 7-year period. A total of 307 hospital-acquired CDI patients were enrolled, and 70.7% of these cases were male. CDI incidence was 3.4 per 10,000 admissions. Thirty-three different sequence types (STs) were identified, among which ST-54 (18.2%), ST-35 (16.6%) and ST-37 (12.1%) were the most prevalent. During the follow-up period, 66 (21.5%) patients developed severe CDI and 32 (10.4%) patients died in 30 days. Multivariate analysis revealed that bloodstream infection, pulmonary infection and C-reactive protein were significantly associated with severe CDI. After adjustment for potential confounders, old age, bloodstream infection, fever, mechanical ventilation, connective tissue disease, macrolide use and hypoalbuminaemia were independently associated with 30-day mortality in patients with CDI. The CDI prevalence has been low and stable in our center, and STs of Clostridium difficile were different from dominant STs in Western countries. Our data emphasize the need of continued education and surveillance of CDI to reduce the CDI burden in China.
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spelling pubmed-55751022017-09-01 Hospital-acquired Clostridium difficile infection in Mainland China: A seven-year (2009–2016) retrospective study in a large university hospital Xu, Qiaomai Chen, Yunbo Gu, Silan Lv, Tao Zheng, Beiwen Shen, Ping Quan, Jiazheng Fang, Yunhui Li, Lanjuan Sci Rep Article Clostridium difficile infection (CDI) is associated with risk for severe disease and high mortality. Little is known about the extent of hospital-acquired CDI in Mainland China. In this study, we aimed to investigate the annual CDI incidence, bacterial genotypes, risk factors for severe CDI and survival over a 7-year period. A total of 307 hospital-acquired CDI patients were enrolled, and 70.7% of these cases were male. CDI incidence was 3.4 per 10,000 admissions. Thirty-three different sequence types (STs) were identified, among which ST-54 (18.2%), ST-35 (16.6%) and ST-37 (12.1%) were the most prevalent. During the follow-up period, 66 (21.5%) patients developed severe CDI and 32 (10.4%) patients died in 30 days. Multivariate analysis revealed that bloodstream infection, pulmonary infection and C-reactive protein were significantly associated with severe CDI. After adjustment for potential confounders, old age, bloodstream infection, fever, mechanical ventilation, connective tissue disease, macrolide use and hypoalbuminaemia were independently associated with 30-day mortality in patients with CDI. The CDI prevalence has been low and stable in our center, and STs of Clostridium difficile were different from dominant STs in Western countries. Our data emphasize the need of continued education and surveillance of CDI to reduce the CDI burden in China. Nature Publishing Group UK 2017-08-29 /pmc/articles/PMC5575102/ /pubmed/28852010 http://dx.doi.org/10.1038/s41598-017-09961-0 Text en © The Author(s) 2017 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Xu, Qiaomai
Chen, Yunbo
Gu, Silan
Lv, Tao
Zheng, Beiwen
Shen, Ping
Quan, Jiazheng
Fang, Yunhui
Li, Lanjuan
Hospital-acquired Clostridium difficile infection in Mainland China: A seven-year (2009–2016) retrospective study in a large university hospital
title Hospital-acquired Clostridium difficile infection in Mainland China: A seven-year (2009–2016) retrospective study in a large university hospital
title_full Hospital-acquired Clostridium difficile infection in Mainland China: A seven-year (2009–2016) retrospective study in a large university hospital
title_fullStr Hospital-acquired Clostridium difficile infection in Mainland China: A seven-year (2009–2016) retrospective study in a large university hospital
title_full_unstemmed Hospital-acquired Clostridium difficile infection in Mainland China: A seven-year (2009–2016) retrospective study in a large university hospital
title_short Hospital-acquired Clostridium difficile infection in Mainland China: A seven-year (2009–2016) retrospective study in a large university hospital
title_sort hospital-acquired clostridium difficile infection in mainland china: a seven-year (2009–2016) retrospective study in a large university hospital
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5575102/
https://www.ncbi.nlm.nih.gov/pubmed/28852010
http://dx.doi.org/10.1038/s41598-017-09961-0
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