Antibiotic susceptibility of Clostridium difficile is similar worldwide over two decades despite widespread use of broad-spectrum antibiotics: an analysis done at the University Hospital of Zurich

BMC Infectious Diseases

Research Article

Andrea C Büchler¹  Roberto F Speck¹  Bruno Ledergerber¹  Simon Stelling²  Christian Ruef³  Alexander Schweiger⁴  Silvana K Rampini⁵  Reinhard Zbinden⁶  Silke Peter⁷ 

[1] Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland;Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland;Ergon Informatik AG, Kleinstrasse 15, 8008, Zürich, Switzerland;Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland;Hirslanden Klinik, Witellikerstrasse 40, 8032, Zürich, Switzerland;Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland;Internal Medicine, Hospital Schwyz, Waldeggstrasse 10, 6430, Schwyz, Switzerland;Division of Internal Medicine, University Hospital of Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland;Institute of Medical Microbiology, University of Zurich, Gloriastrasse 30/32, 8006, Zurich, Switzerland;Institute of Medical Microbiology, University of Zurich, Gloriastrasse 30/32, 8006, Zurich, Switzerland;Institute of Medical Microbiology and Hygiene, University of Tübingen, Elfriede-Aulhorn Str. 6, Tübingen, Germany;

关键词: Clostridium difficile;    Antibiotic susceptibility;    Diarrhea;    EUCAST;   

DOI  :  10.1186/s12879-014-0607-z

 received in 2014-01-15, accepted in 2014-11-03,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundClostridium difficile infection (CDI) remains a major health problem worldwide. Antibiotic use, in general, and clindamycin and ciprofloxacin, in particular, have been implicated in the pathogenesis of CDI. Here, we hypothesized that antibiotics that are highly active in vitro against C. difficile are less frequently associated with CDI than others. The primary goals of our study were to determine if antibiotic susceptibility and CDI are associated and whether the antimicrobial susceptibility of C. difficile changed over the years.Methods and resultsWe examined a large panel of C. difficile strains collected in 2006-2008 at the University Hospital of Zurich. We found that the antimicrobial susceptibilities to amoxicillin/clavulanate, piperacillin/tazobactam, meropenem, clindamycin, ciprofloxacin, ceftriaxone, metronidazole and vancomycin were similar to those reported in the literature and that they are similar to those reported in other populations over the last two decades. Antibiotic activity did not prevent CDI. For example, thre use of meropenem, which is highly active against all strains tested, was a clear risk factor for CDI. Most of the antibiotics tested also showed a higher minimum inhibitory concentration distribution than that of EUCAST. All strains were susceptible to metronidazole. One strain was resistant to vancomycin.ConclusionsAntibiotic susceptibilities of the collection of C. difficile from the University Hospital of Zurich are similar to those reported by others since the 1980. Patients treated with carbapenems and cephalosporins had the highest risk of developing CDI irrespective of the antimicrobial activity of carbapenems.

【 授权许可】

Unknown   
© Büchler et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.