Clostridioides difficile infection in the Asia-Pacific region

Clostridioides difficile causes healthcare-related diarrhoea in high-income countries. Highly resistant spores persist in healthcare facilities, primarily infecting patients who have recently received antimicrobials. C. difficile infection (CDI) has been studied in detail in North America and Europe...

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Main Authors: Deirdre A. Collins, Kyung Mok Sohn, Yuan Wu, Kentaro Ouchi, Yoshikazu Ishii, Briony Elliott, Thomas V. Riley, Kazuhiro Tateda
Format: Article
Language:English
Published: Taylor & Francis Group 2020-01-01
Series:Emerging Microbes and Infections
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Online Access:https://www.tandfonline.com/doi/10.1080/22221751.2019.1702480
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author Deirdre A. Collins
Kyung Mok Sohn
Yuan Wu
Kentaro Ouchi
Yoshikazu Ishii
Briony Elliott
Thomas V. Riley
Kazuhiro Tateda
author_facet Deirdre A. Collins
Kyung Mok Sohn
Yuan Wu
Kentaro Ouchi
Yoshikazu Ishii
Briony Elliott
Thomas V. Riley
Kazuhiro Tateda
author_sort Deirdre A. Collins
collection DOAJ
description Clostridioides difficile causes healthcare-related diarrhoea in high-income countries. Highly resistant spores persist in healthcare facilities, primarily infecting patients who have recently received antimicrobials. C. difficile infection (CDI) has been studied in detail in North America and Europe; however, the epidemiology of CDI elsewhere, including the Asia-Pacific region, is largely unknown. A survey of CDI was performed in 13 Asia-Pacific countries. Epidemiological data on 600 cases were collected and molecular typing undertaken on 414 C. difficile isolates. Healthcare facility-associated CDI comprised 53.6% of cases, while community-associated CDI was 16.5%. The median age of cases was 63.0 years and 45.3% were female, 77.5% had used antibiotics in the previous 8 weeks, most frequently third-generation cephalosporins (31.7%), and 47.3% had used proton pump inhibitors. Recurrence (9.1%) and mortality (5.2%) rates were low, while complications including colitis or pseudomembranous colitis (13.8%), colectomy (0.4%), and toxic megacolon (0.2%) were uncommon. Common C. difficile strains were ribotypes 017 (16.7%), 014/020 (11.1%) and 018 (9.9%), with wide variation between countries. Binary toxin-positive strains of C. difficile were detected rarely. Overall, disease severity appeared mild, and mortality and recurrence were low. Continued education about, and surveillance of, CDI in Asia are required to reduce the burden of disease.
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spelling doaj-art-b5321f692e814e8ebd6421da0469a1dd2025-08-20T02:16:11ZengTaylor & Francis GroupEmerging Microbes and Infections2222-17512020-01-0191425210.1080/22221751.2019.1702480Clostridioides difficile infection in the Asia-Pacific regionDeirdre A. Collins0Kyung Mok Sohn1Yuan Wu2Kentaro Ouchi3Yoshikazu Ishii4Briony Elliott5Thomas V. Riley6Kazuhiro Tateda7School of Biomedical Sciences, The University of Western Australia, Perth, AustraliaDivision of Infectious Diseases, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of KoreaState Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of ChinaMedical Affairs, Otsuka Pharmaceutical Co., Ltd, Osaka, JapanDepartment of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, JapanSchool of Biomedical Sciences, The University of Western Australia, Perth, AustraliaSchool of Biomedical Sciences, The University of Western Australia, Perth, AustraliaDepartment of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, JapanClostridioides difficile causes healthcare-related diarrhoea in high-income countries. Highly resistant spores persist in healthcare facilities, primarily infecting patients who have recently received antimicrobials. C. difficile infection (CDI) has been studied in detail in North America and Europe; however, the epidemiology of CDI elsewhere, including the Asia-Pacific region, is largely unknown. A survey of CDI was performed in 13 Asia-Pacific countries. Epidemiological data on 600 cases were collected and molecular typing undertaken on 414 C. difficile isolates. Healthcare facility-associated CDI comprised 53.6% of cases, while community-associated CDI was 16.5%. The median age of cases was 63.0 years and 45.3% were female, 77.5% had used antibiotics in the previous 8 weeks, most frequently third-generation cephalosporins (31.7%), and 47.3% had used proton pump inhibitors. Recurrence (9.1%) and mortality (5.2%) rates were low, while complications including colitis or pseudomembranous colitis (13.8%), colectomy (0.4%), and toxic megacolon (0.2%) were uncommon. Common C. difficile strains were ribotypes 017 (16.7%), 014/020 (11.1%) and 018 (9.9%), with wide variation between countries. Binary toxin-positive strains of C. difficile were detected rarely. Overall, disease severity appeared mild, and mortality and recurrence were low. Continued education about, and surveillance of, CDI in Asia are required to reduce the burden of disease.https://www.tandfonline.com/doi/10.1080/22221751.2019.1702480Clostridioides difficile infectionAsia-Pacificepidemiologyclinical featuresmolecular epidemiology
spellingShingle Deirdre A. Collins
Kyung Mok Sohn
Yuan Wu
Kentaro Ouchi
Yoshikazu Ishii
Briony Elliott
Thomas V. Riley
Kazuhiro Tateda
Clostridioides difficile infection in the Asia-Pacific region
Emerging Microbes and Infections
Clostridioides difficile infection
Asia-Pacific
epidemiology
clinical features
molecular epidemiology
title Clostridioides difficile infection in the Asia-Pacific region
title_full Clostridioides difficile infection in the Asia-Pacific region
title_fullStr Clostridioides difficile infection in the Asia-Pacific region
title_full_unstemmed Clostridioides difficile infection in the Asia-Pacific region
title_short Clostridioides difficile infection in the Asia-Pacific region
title_sort clostridioides difficile infection in the asia pacific region
topic Clostridioides difficile infection
Asia-Pacific
epidemiology
clinical features
molecular epidemiology
url https://www.tandfonline.com/doi/10.1080/22221751.2019.1702480
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