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Epidemiological and genomic characterization of community-acquired Clostridium difficile infections

Overview of attention for article published in BMC Infectious Diseases, August 2018
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Title
Epidemiological and genomic characterization of community-acquired Clostridium difficile infections
Published in
BMC Infectious Diseases, August 2018
DOI 10.1186/s12879-018-3337-9
Pubmed ID
Authors

Christina S. Thornton, Joseph E. Rubin, Alexander L. Greninger, Gisele Peirano, Charles Y. Chiu, Dylan R. Pillai

Abstract

Clostridium difficile infection (CDI) is a major cause of morbidity and mortality in North America and Europe. The aim of this study was to identify epidemiologically-confirmed cases of community-acquired (CA)-CDI in a large North American urban center and analyze isolates using multiple genetic and phenotypic methods. Seventy-eight patients testing positive for C. difficile from outpatient clinics were further investigated by telephone questionnaire. CA-CDI isolates were characterized by antibiotic susceptibility, pulsed-field gel electrophoresis and whole genome sequencing. CA-CDI was defined as testing positive greater than 12 weeks following discharge or no previous hospital admission in conjunction with positive toxin stool testing. 51.3% (40/78) of the patients in this study were found to have bona fide CA-CDI. The majority of patients were female (71.8% vs. 28.2%) with 50-59 years of age being most common (21.8%). Common co-morbidities included ulcerative colitis (1/40; 2.5%), Crohn's disease (3/40; 7.5%), celiac disease (2/40; 5.0%) and irritable bowel syndrome (8/40; 20.0%). However, of 40 patients with CA-CDI, 9 (29.0%) had been hospitalized between 3 and 6 months prior and 31 (77.5%) between 6 and 12 months prior. The hypervirulent North American Pulostype (NAP) 1-like (9/40; 22.5%) strain was the most commonly identified pulsotype. Whole genome sequencing of CA-CDI isolates confirmed that NAP 1-like pulsotypes are commonplace in CA-CDI. From a therapeutic perspective, there was universal susceptibility to metronidazole and vancomycin. All CA-CDI cases had some history of hospitalization if the definition were modified to health care facility exposure in the last 12 months and is supported by the genomic analysis. This raises the possibility that even CA-CDI may have nosocomial origins.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 20 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 20 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 5 25%
Researcher 3 15%
Student > Doctoral Student 2 10%
Other 2 10%
Student > Ph. D. Student 2 10%
Other 4 20%
Unknown 2 10%
Readers by discipline Count As %
Immunology and Microbiology 5 25%
Medicine and Dentistry 4 20%
Nursing and Health Professions 2 10%
Agricultural and Biological Sciences 2 10%
Pharmacology, Toxicology and Pharmaceutical Science 1 5%
Other 3 15%
Unknown 3 15%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 September 2018.
All research outputs
#10,270,572
of 13,459,952 outputs
Outputs from BMC Infectious Diseases
#3,176
of 5,018 outputs
Outputs of similar age
#183,516
of 265,176 outputs
Outputs of similar age from BMC Infectious Diseases
#1
of 1 outputs
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