The association of a reduced susceptibility to moxifloxacin in causativeClostridium(Clostridioides)difficilestrain with the clinical outcome of patients
| Authors | |
|---|---|
| Year of publication | 2020 |
| Type | Article in Periodical |
| Magazine / Source | ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL |
| MU Faculty or unit | |
| Citation | |
| Web | https://aricjournal.biomedcentral.com/track/pdf/10.1186/s13756-020-00765-y |
| Doi | http://dx.doi.org/10.1186/s13756-020-00765-y |
| Keywords | Clostridium difficileinfection; Clostridioides difficileinfection; Czech Republic; PCR ribotype 001; PCR ribotype 176; Moxifloxacin; Mortality |
| Description | Objectives To investigate the relationship betweenClostridium (Clostridioides) difficilestrain characteristics andC. difficileinfection (CDI) outcome. Methods Between October and December 2017, 16 hospitals collected epidemiological data according to the European Centre for Disease Prevention and Control (ECDC) surveillance protocol for CDI.C. difficileisolates were characterized by ribotyping, toxin genes detection and antibiotic susceptibility testing to metronidazole, vancomycin and moxifloxacin. Results The overall mean CDI incidence density was 4.5 [95% CI 3.6-5.3] cases per 10,000 patient-days. From the 433 CDI cases, 330 (76.2%) were healthcare-associated, 52 (12.0%) cases were community-associated or of unknown origin and 51 (11.8%) CDI cases recurrent; a complicated course of CDI was reported in 65 cases (15.0%). Eighty-eight (20.3%) of patients died and 59 of them within 30 days after the CDI diagnosis. From the 379C. difficileisolates, the most prevalent PCR ribotypes were 001 (n = 127, 33.5%) and 176 (n = 44, 11.6%). A total of 186 (49.1%) isolates showed a reduced susceptibility to moxifloxacin (> 4 mg/L) and 96.4% of them had Thr82Ile in the GyrA. Nineteen isolates revealed reduced susceptibility to metronidazole and two isolates to vancomycin (> 2 mg/L). A fatal outcome was associated with a reduced susceptibility to moxifloxacin, the advanced age of the patients and a complicated course of CDI (p<0.05). No association between ribotype, binary toxin and a reduced susceptibility to moxifloxacin and complicated course or recurrent CDI was found. Conclusions A reduced susceptibility to moxifloxacin, in causativeC. difficilestrains was associated with fatal outcome of the patients, therefore it is an important marker in surveillance of CDI. |