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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
김지은
Keywords
Clostridium difficile infection; tcdA-negative variant strain; Clinical outcome; Risk factor; Antimicrobial susceptibility test; ermB gene
Issue Date
2012-05
Publisher
BIOMED CENTRAL LTD
Citation
BMC Infectious Diseases, 2012, 12
Abstract
Background: The 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.Methods: From 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.Results: During 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).Conclusions: The 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
http://iopscience.iop.org/article/10.1088/0957-4484/23/18/185307/metahttps://repository.hanyang.ac.kr/handle/20.500.11754/70162
ISSN
1471-2334
DOI
10.1088/0957-4484/23/18/185307
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COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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