Characterization of a Clostridioides difficile outbreak caused by PCR ribotype 046, associated with increased mortality. Issue 1 (31st December 2022)

• Record Type: Journal Article
• Authors: Magnusson, Cecilia; Mernelius, Sara; Bengnér, Malin; Norén, Torbjörn; Serrander, Lena; Forshell, Sophie; Matussek, Andreas
• Is Part Of: Emerging microbes & infections. Volume 11:Issue 1(2022)
• Page Start: 850
• Page End: 859
• Publication Date: 2022-12-31
• Subjects: Clostridioides difficile -- CDI -- mortality -- outbreak -- epidemiology -- ribotyping -- whole-genome sequencing; Medical microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.9041
• DOI: 10.1080/22221751.2022.2049981
• Languages: English
• ISSNs: 2222-1751

Abstract

ABSTRACT: This study describes a large nosocomial outbreak of Clostridioides difficile infections (CDI) dominated by ribotype (RT) 046 in a Swedish hospital. The present study aimed to examine the pathogenicity of this RT, explore epidemiological links by whole genome sequencing (WGS), and evaluate different interventions implemented to stop the outbreak. Clinical isolates ( n = 366) collected during and after the outbreak were ribotyped and 246 isolates were subjected to WGS. Medical records of patients infected with the seven most common RTs were evaluated. RT046 was spread effectively throughout the hospital and was the most common among the 44 different RTs found (114/366 isolates). Infection with RT046 was associated with higher mortality compared to other strains (20.2% to 7.8%), although there were no differences in concomitant disease, age or antibiotic treatment. To control the outbreak, several measures were successfully implemented.