Gabriel Adrian POPESCU, Roxana SERBAN, Adriana PİSTOL, Andreea NİCULCEA, Andreea PREDA, Daniela LEMENİ, Ioana Sabina MACOVEİ, Daniela T?L?PAN, Alexandru RAFİLA, Dragoş FLOREA

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

Aims: To investigate the epidemiology of Clostridium difficileinfection in Romanian hospitals.Methods: A survey was conducted at nine hospitals throughoutRomania between November 2013 and February 2014.Results: The survey identified 393 patients with Clostridium difficileinfection. The median age was 67 years (range: 2-94 years); 56% ofpatients were aged >65 years. The mean prevalence of Clostridiumdifficile infection was 5.2 cases per 10.000 patient-days. The highestprevalences were 24.9 and 20 per 10.000 patient-days in hospitalsspecializing in gastroenterology and infectious diseases, respectively.Clostridium difficile infections were health care-associated in 70.5%patients and community-acquired in 10.2%. The origin was notdetermined in 19.3%. Clostridium difficile infection was severe in12.3% of patients, and the in-hospital all-cause mortality was 8.8%.Polymerase chain reaction ribotype 027 had the highest prevalence inall participating hospitals and represented 82.6% of the total ribotypedisolates. The minimum inhibitory concentration of moxifloxacin was>4 μg/mL for 59 of 80 tested isolates (73.8%). Of 59 isolates, 54 werehighly resistant to moxifloxacin (minimum inhibitory concentration≥32 μg/mL), and the majority were polymerase chain reactionribotype 027 (p

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