Clostridium difficile PCR ribotype 027: assessing the risks of further worldwide spread

被引:155
作者
Clements, Archie C. A. [1 ,2 ]
Magalhaes, Ricardo J. Soares [1 ]
Tatem, Andrew J. [3 ,4 ]
Paterson, David L. [5 ]
Riley, Thomas V. [6 ]
机构
[1] Univ Queensland, Sch Populat Hlth, Herston, Qld 4006, Australia
[2] Queensland Inst Med Res, Australian Ctr Int & Trop Hlth, Herston, Qld 4006, Australia
[3] Univ Florida, Dept Geog, Gainesville, FL 32611 USA
[4] Univ Florida, Emerging Pathogens Inst, Gainesville, FL 32611 USA
[5] Univ Queensland, Clin Res Ctr, Royal Brisbane & Womens Hosp, Herston, Qld 4006, Australia
[6] Univ Western Australia, Queen Elizabeth II Med Ctr, Dept Microbiol, Nedlands, WA 6009, Australia
基金
英国医学研究理事会;
关键词
ANTIMICROBIAL USE DATA; USE DATA-COLLECTION; UNITED-STATES; MOLECULAR ANALYSIS; MULTIINSTITUTIONAL OUTBREAK; HOSPITALIZED-PATIENTS; HYPERVIRULENT STRAIN; RESPIRATORY SYNDROME; FLUOROQUINOLONE USE; CLINICAL-FEATURES;
D O I
10.1016/S1473-3099(10)70080-3
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Highly virulent strains of Clostridium difficile have emerged since 2003, causing large outbreaks of severe, often fatal, colitis in North America and Europe. In 2008-10, virulent strains spread between continents, with the first reported cases of fluoroquinolone-resistant C difficile PCR ribotype 027 in three Asia-Pacific countries and Central America. We present a risk assessment framework for assessing risks of further worldwide spread of this pathogen. This framework first requires identification of potential vehicles of introduction, including international transfers of hospital patients, international tourism and migration, and trade in livestock, associated commodities, and foodstuffs. It then calls for assessment of the risks of pathogen release, of exposure of individuals if release happens, and of resulting outbreaks. Health departments in countries unaffected by outbreaks should assess the risk of introduction or reintroduction of C difficile PCR ribotype 027 using a structured risk-assessment approach.
引用
收藏
页码:395 / 404
页数:10
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