Extraintestinal <i>Clostridioides difficile</i> Infections: Epidemiology in a University Hospital in Hungary and Review of the Literature

• Main Authors: Edit Urbán (Author), Gabriella Terhes (Author), Márió Gajdács (Author)
• Format: Book
• Published: MDPI AG, 2020-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2079-6382; 10.3390/antibiotics9010016
• Keywords: <i>clostridioides difficile</i>; extraintestinal; infection; bacteremia; intraoperative infections; abscess; wound infection; epidemiology; anaerobes; Therapeutics. Pharmacology; RM1-950
• Source: Antibiotics, Vol 9, Iss 1, p 16 (2020)

Extraintestinal manifestations of <i>Clostridioides difficile</i> infections (CDIs) are very uncommon, and according to the literature, poor outcomes and a high mortality have been observed among affected individuals. The objective of this study was to investigate the incidence rate of extraintestinal infections caused by <i>C. difficile</i> (ECD) in a tertiary-care university hospital in Hungary. During a 10-year study period, the microbiology laboratory isolated 4129 individual strains of <i>C. difficile</i>; among these, the majority were either from diarrheal fecal samples or from colonic material and only <i>n</i> = 24 (0.58%) were from extraintestinal sources. The 24 extraintestinal <i>C. difficile</i> isolates were recovered from 22 patients (female-to-male ratio: 1, average age: 55.4 years). The isolates in <i>n</i> = 8 patients were obtained from abdominal infections, e.g., appendicitis, rectal abscess or Crohn’s disease. These extraintestinal cases occurred without concomitant diarrhea. In all, but two cases <i>C. difficile</i> was obtained as a part of a polymicrobial flora. Our isolates were frequently toxigenic and mostly belonged to PCR ribotype 027. Resistance to metronidazole, vancomycin, clindamycin and rifampin were 0%, 0%, 20.5% and 9.7%, respectively. The increasing amount of reports of <i>C. difficile</i> extraintestinal infections should be noted, as these infections are characterized by a poor outcome and high mortality rate.