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Increase of Clostridium difficile in Community; Another Worrisome Burden for Public Health

Other Titles
 공중보건에 부담이 되는 Clostridium difficile 지역사회 감염의 증가 
Authors
 김영아  ;  임정훈  ;  최민혁  ;  김희정  ;  이경원 
Citation
 Annals of Clinical Microbiology, Vol.19(1) : 7-12, 2016 
Journal Title
 Annals of Clinical Microbiology 
ISSN
 2288-0585 
Issue Date
2016
Keywords
Clostridium difficile toxin B ; Communityacquired infection ; Epidemiology
Abstract
Background: Increasing rates of Clostridium difficile infection (CDI) have been reported mainly in Europe and North America; however, only limited reports have originated in Korea. The current epidemiology of CDI in the community could help to understand the outpatient healthcare environment and to extend infection control measures to outpatient settings. Methods: C. difficile isolates in NHIS Ilsan Hospital from 2012 to 2014 were included in this study. Clinical characteristics, acquisition types, and previous antimicrobial therapy were obtained via Electronic Medical Records. C. difficile culture was performed only in unformed stool. Toxin was positive by enzyme-linked fluorescent immunoassay (ELFA) in 247 specimens. In addition, toxin B and binary toxin gene were detected by PCR in 57 specimens. CDI was defined by toxigenic C. difficile isolation in unformed stool. Results: In the previous 3 years, 251 unduplicated C. difficile cases have been detected; 168 healthcare facility- associated hospital onset (HCFA-HO), 45 healthcare facility-associated community onset (HCFA-CO), and 38 community-associated (CA). Toxin positive rates by ELFA for toxin A&B were HCFA-HO 50.6% (84/166), HCFA-CO 41.9% (18/43), and CA 42.1% (16/38). Toxin positive rate by PCR for tcdB were HCFA-HO 62.9% (22/35), HCFA-CO 69.2% (9/13), and CA 100% (9/9). No binary toxin (cdtA/cdtB) was detected in 57 cases. Conclusion: Community-associated CDI may be underestimated in Goyang province, Korea, especially by commonly used ELFA toxin assay. The spread of community-associated CDI should be recognized as an increasing burden of public health.
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DOI
10.5145/ACM.2016.19.1.7
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Heejung(김희정) ORCID logo https://orcid.org/0000-0002-0190-703X
Lee, Kyungwon(이경원) ORCID logo https://orcid.org/0000-0003-3788-2134
Rim, John Hoon(임정훈) ORCID logo https://orcid.org/0000-0001-6825-8479
Choi, Min Hyuk(최민혁)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146694
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