The Recent Emergence of Clostridium difficile Infection in Romanian Hospitals is Associated with a High Prevalence of Polymerase Chain Reaction Ribotype 027

• Published in: Balkan medical journal Vol. 35; no. 2; pp. 191 - 195
• Main Authors: Popescu, Gabriel Adrian, Serban, Roxana, Pistol, Adriana, Niculcea, Andreea, Preda, Andreea, Lemeni, Daniela, Macovei, Ioana Sabina, Tălăpan, Daniela, Rafila, Alexandru, Florea, Dragoş
• Format: Journal Article
• Language: English
• Published: Turkey Trakya Üniversitesi 01.03.2018; Aves Yayincilik Ltd. STI; Galenos Publishing; Galenos Publishing House
• Subjects: Brief Report; Clostridium difficile; Clostridium difficile - genetics; Clostridium difficile - isolation & purification; Clostridium Infections - epidemiology; Cross Infection - epidemiology; Epidemiology; Genes; Health surveillance; Hospitals; Humans; Infections; Infectious diseases; Patients; Polymerase chain reaction; Polymerase Chain Reaction - methods; Prevalence; Public health; ribotype 027; Ribotyping; Romania; Romania - epidemiology; Studies; Tıp; Toxins; Romania; Türkiye; Edirne; United Kingdom > UK; France; United States > US; Europe; Latin America; epidemiology; ribotype 027 Romania; Clostridium difficile; ribotype 027; Romania
• ISSN: 2146-3123; 2146-3131
• DOI: 10.4274/balkanmedj.2017.0400

To investigate the epidemiology of infection in Romanian hospitals. A survey was conducted at nine hospitals throughout Romania between November 2013 and February 2014. The survey identified 393 patients with infection. The median age was 67 years (range: 2-94 years); 56% of patients were aged >65 years. The mean prevalence of infection was 5.2 cases per 10.000 patient-days. The highest prevalences were 24.9 and 20 per 10.000 patient-days in hospitals specializing in gastroenterology and infectious diseases, respectively. infections were health care-associated in 70.5% patients and community-acquired in 10.2%. The origin was not determined in 19.3%. infection was severe in 12.3% of patients, and the in-hospital all-cause mortality was 8.8%. Polymerase chain reaction ribotype 027 had the highest prevalence in all participating hospitals and represented 82.6% of the total ribotyped isolates. The minimum inhibitory concentration of moxifloxacin was >4 μg/mL for 59 of 80 tested isolates (73.8%). Of 59 isolates, 54 were highly resistant to moxifloxacin (minimum inhibitory concentration ≥32 μg/mL), and the majority were polymerase chain reaction ribotype 027 (p<0.0001). The ribotype 027 was the predominant cause of infections in Romania. In some specialized hospitals, the prevalence of infection was higher than the European mean prevalence, and this demonstrates the need for strict adherence to infection control programs.