Characterization of Healthcare-Associated and Community-Associated Clostridioides difficile Infections among Adults, Canada, 2015-2019

被引：23

作者：

Du, Tim ^{[1
]}

Choi, Kelly B. ^{[2
]}

Silva, Anada ^{[2
]}

Golding, George R. ^{[1
]}

Pelude, Linda ^{[2
]}

Hizon, Romeo ^{[1
]}

Al-Rawahi, Ghada N. ^{[3
]}

Brooks, James ^{[2
]}

Chow, Blanda ^{[4
]}

Collet, Jun C. ^{[5
]}

Comeau, Jeannette L. ^{[6
]}

Davis, Ian ^{[7
]}

Evans, Gerald A. ^{[8
]}

Frenette, Charles ^{[9
]}

Han, Guanghong ^{[10
]}

Johnstone, Jennie ^{[11
]}

Kibsey, Pamela ^{[12
]}

Katz, Kevin C. ^{[13
]}

Langley, Joanne M. ^{[14
]}

Lee, Bonita E. ^{[15
]}

Longtin, Yves ^{[16
]}

Mertz, Dominik ^{[17
]}

Minion, Jessica ^{[18
]}

Science, Michelle ^{[19
]}

Srigley, Jocelyn A. ^{[5
]}

Stagg, Paula ^{[20
]}

Suh, Kathryn N. ^{[21
]}

Thampi, Nisha ^{[22
]}

Wong, Alice ^{[23
]}

Hota, Susy S. ^{[24
]}

机构：

[1] Natl Microbiol Lab, Winnipeg, MB, Canada

[2] Publ Hlth Agcy Canada, Ottawa, ON, Canada

[3] British Columbia Childrens Hosp, Vancouver, BC, Canada

[4] Alberta Hlth Serv, Calgary, AB, Canada

[5] BC Childrens & Womens Hosp, Vancouver, BC, Canada

[6] Dalhousie Univ, Halifax, NS, Canada

[7] Queen Elizabeth 2 Hlth Sci Ctr, Halifax, NS, Canada

[8] Kingston Hlth Sci Ctr, Kingston, ON, Canada

[9] McGill Univ, Hlth Ctr, Montreal, PQ, Canada

[10] Prov Infect Control Network, Vancouver, BC, Canada

[11] Sinai Hlth, Toronto, ON, Canada

[12] Royal Jubilee Hosp, Victoria, BC, Canada

[13] North York Gen Hosp, Toronto, ON, Canada

[14] IWK Hlth Ctr, Halifax, NS, Canada

[15] Stollery Childrens Hosp, Edmonton, AB, Canada

[16] Jewish Gen Hosp, Montreal, PQ, Canada

[17] Hamilton Hlth Sci, Hamilton, ON, Canada

[18] Regina Gen Hosp, Regina, SK, Canada

[19] Hosp Sick Children, Toronto, ON, Canada

[20] Western Mem Reg Hosp, Corner Brook, NL, Canada

[21] Ottawa Hosp, Ottawa, ON, Canada

[22] Childrens Hosp Eastern Ontario, Ottawa, ON, Canada

[23] Royal Univ Hosp, Saskatoon, SK, Canada

[24] Univ Hlth Network, Toronto, ON, Canada

来源：

EMERGING INFECTIOUS DISEASES | 2022年 / 28卷 / 06期

关键词：

ANTIMICROBIAL RESISTANCE; SURVEILLANCE; HOSPITALS; RIBOTYPE;

D O I：

10.3201/eid2806.212262

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

We investigated epidemiologic and molecular characteristics of healthcare-associated (HA) and community-associated (CA) Clostridioides difficile infection (CDI) among adult patients in Canadian Nosocomial Infection Surveillance Program hospitals during 2015-2019. The study encompassed 18,455 CDI cases, 13,735 (74.4%) HA and 4,720 (25.6%) CA. During 2015-2019, HA CDI rates decreased by 23.8%, whereas CA decreased by 18.8%. HA CDI was significantly associated with increased 30-day all-cause mortality as compared with CA CDI (p<0.01). Of 2,506 isolates analyzed, the most common ribotypes (RTs) were RT027, RT106, RT014, and RT020. RT027 was more often associated with CDI-attributable death than was non-RT027, regardless of acquisition type. Overall resistance C. difficile rates were similar for all drugs tested except moxifloxacin. Adult HA and CA CDI rates have declined, coinciding with changes in prevalence of RT027 and RT106. Infection prevention and control and continued national surveillance are integral to clarifying CDI epidemiology, investigation, and control.

引用

页码：1128 / 1136

页数：9

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