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Clinical and microbiologic characteristics of tcdA-negative variant clostridium difficile infections

Title
Clinical and microbiologic characteristics of tcdA-negative variant clostridium difficile infections
Author
서미란
Keywords
Clostridium difficile infection; tcdA-negative variant strain; Clinical outcome; Risk factor; Antimicrobial susceptibility test; ermB gene
Issue Date
2012-07
Publisher
BioMed Central Ltd.
Citation
BMC Infectious Diseases, 2012, 12, P.109
Abstract
BackgroundThe tcdA-negative variant (A-B+) of Clostridium difficile is prevalent in East Asian countries. However, the risk factors and clinical characteristics of A-B+ C. difficile infections (CDI) are not clearly documented. The objective of this study was to investigate these characteristics.MethodsFrom September 2008 through January 2010, the clinical characteristics, medication history and treatment outcomes of CDI patients were recorded prospectively. Toxin characterization and antibiotic susceptibility tests were performed on stool isolates of C. difficile.ResultsDuring the study period, we identified 22 cases of CDI caused by tcdA-negative tcdB-positive (A-B+) strains and 105 cases caused by tcdA-positive tcdB-positive (A+B+) strains. There was no significant difference in disease severity or clinical characteristics between the two groups. Previous use of clindamycin and young age were identified as significant risk factors for the acquisition of A-B+ CDI (OR = 4.738, 95% CI 1.48–15.157, p = 0.009 and OR = 0.966, 95% CI 0.935–0.998, p = 0.038, respectively) in logistic regression.Rates of resistance to clindamycin were 100% and 69.6% in the A-B+ and A+B+ isolates, respectively (p = 0.006), and the ermB gene was identified in 17 of 21 A-B+ isolates (81%). Resistance to moxifloxacin was also more frequent in the A-B+ than in the A+B+ isolates (95.2% vs. 63.7%, p = 0.004).ConclusionsThe clinical course of A-B+ CDI is not different from that of A+B+ CDI. Clindamycin use is a significant risk factor for the acquisition of tcdA-negative variant strains.
URI
https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-12-109http://hdl.handle.net/20.500.11754/66336
ISSN
1471-2334
DOI
10.1186/1471-2334-12-109
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RESEARCH INSTITUTE[S](부설연구소) > ETC
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