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Author’s VersionCC BY-NC-ND V4.0, Open Access
Journal article
The emergence of community-onset Clostridium difficile infection in a tertiary hospital in Singapore: A cause for concern
International Journal of Antimicrobial Agents, Vol.43(1), pp.47-51
2014
Abstract
Increasing rates of Clostridium difficile infection (CDI) among those without traditional risk factors have been reported mainly in Europe and North America. Here we describe the epidemiology, clinical features and ribotypes of CDI at National University Hospital (NUH), a 1000-bed tertiary care hospital in Singapore, from December 2011 to May 2012. All laboratory-confirmed CDI cases ≥21 years old who gave informed consent were included. Clinical data were collected prospectively and participants underwent an interviewer-administered questionnaire. Cases were classified by healthcare facility exposure and severity according to the SHEA guidelines. Included cases were also subjected to PCR and were classified by ribotype. In total, 66 patients participated in the study, of which 33 (50.0%) were healthcare-facility-associated hospital onset (HCFA-HO). Of the 33 community-onset (CO) cases, 14 (42.4%) were HCFA-CO, 10 (30.3%) were indeterminate and 9 (27.3%) were community-associated (CA). Of the CA cases, a majority (90.9%) had prior exposure to a healthcare facility within the last 12 weeks. Clinical characteristics, exposures and outcomes were not different between HO-CDI and CO-CDI. Diagnosis was delayed in CO-CDI compared with HO-CDI (4 days vs. 1 day; P = 0.014). There was no difference in distribution of ribotypes between CO-CDI and HO-CDI, with 053 being most prevalent in both groups. CO-CDI increasingly contributes to the burden of CDI in NUH. This may reflect a trend in other parts of Asia. Healthcare professionals should be aware of the possible role of outpatient healthcare environments to CDI risk and thus extend control measures to outpatient settings.
Details
- Title
- The emergence of community-onset Clostridium difficile infection in a tertiary hospital in Singapore: A cause for concern
- Authors/Creators
- X.Q. Tan (Author/Creator) - National University Health SystemA.J. Verrall (Author/Creator) - National University Health SystemR. Jureen (Author/Creator) - National University Health SystemT.V. Riley (Author/Creator) - The University of Western AustraliaD.A. Collins (Author/Creator) - The University of Western AustraliaR.T. Lin (Author/Creator) - National University Health SystemM.N. Balm (Author/Creator) - National University Health SystemD. Chan (Author/Creator) - National University Health SystemP.A. Tambyah (Author/Creator) - National University Health System
- Publication Details
- International Journal of Antimicrobial Agents, Vol.43(1), pp.47-51
- Publisher
- Elsevier
- Identifiers
- 991005541885507891
- Copyright
- © 2013 Elsevier B.V. and the International Society of Chemotherapy.
- Murdoch Affiliation
- Murdoch University
- Language
- English
- Resource Type
- Journal article
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- Collaboration types
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- Citation topics
- 1 Clinical & Life Sciences
- 1.120 Inflammatory Bowel Diseases & Infections
- 1.120.1133 Clostridium Infections
- Web Of Science research areas
- Infectious Diseases
- Microbiology
- Pharmacology & Pharmacy
- ESI research areas
- Pharmacology & Toxicology