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BMC Infect Dis. 2014 Nov 26;14:607. doi: 10.1186/s12879-014-0607-z.

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.

Author information

1
Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. andrea.buechler@gmx.ch.
2
Division of Internal Medicine, University Hospital of Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. Silvana.rampini@usz.ch.
3
Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. simon.stelling@ergon.ch.
4
Current address: Ergon Informatik AG, Kleinstrasse 15, 8008, Zürich, Switzerland. simon.stelling@ergon.ch.
5
Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. infled@usz.uzh.ch.
6
Institute of Medical Microbiology, University of Zurich, Gloriastrasse 30/32, 8006, Zurich, Switzerland. silke.peter@med.uni-tuebingen.d.
7
Current address: Institute of Medical Microbiology and Hygiene, University of Tübingen, Elfriede-Aulhorn Str. 6, Tübingen, Germany. silke.peter@med.uni-tuebingen.d.
8
Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. Alexander.Schweiger@spital-schwyz.ch.
9
Current address: Internal Medicine, Hospital Schwyz, Waldeggstrasse 10, 6430, Schwyz, Switzerland. Alexander.Schweiger@spital-schwyz.ch.
10
Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. Christian.ruef@hirslanden.ch.
11
Current address: Hirslanden Klinik, Witellikerstrasse 40, 8032, Zürich, Switzerland. Christian.ruef@hirslanden.ch.
12
Institute of Medical Microbiology, University of Zurich, Gloriastrasse 30/32, 8006, Zurich, Switzerland. rzbinden@imm.uzh.ch.
13
Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. Roberto.speck@usz.ch.

Abstract

BACKGROUND:

Clostridium 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 RESULTS:

We 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.

CONCLUSIONS:

Antibiotic 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.

PMID:
25425433
PMCID:
PMC4247760
DOI:
10.1186/s12879-014-0607-z
[Indexed for MEDLINE]
Free PMC Article

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