PREVALENCE OF CLOSTRIDIUM DIFFICILE PCR RIBOTYPES IN BULGARIA, 2008-2010

Clostridium difficile is one of the most important causative agents of severe diarrhoea in hospitalised patients treated with antibiotics. Since 2008, Bulgaria participated in the Pan-European Surveillance Study investigating the prevalence of C. difficile infections (CDI) in different European countries. In the period November 2008 - March 2010, the incidence of CDI in nine participating hospitals was 7.94 per 10 000 patient admissions (0.34 per 10 000 patient-days). In total, sixty five fecal samples from patients with mild to severe enterocolitis and previous antibiotic treatment were investigated for CDI. Strains were typed and further characterized for the presence of toxins A (TcdA), B (TcdB) and binary toxins (CdtA and CdtB). Of 65 stool samples included, 15 were toxin and culture positive for C. difficile. Six of the isolates (40%) belonged to PCR ribotype 017 (TcdA(-).; TcdB(+); CdtA/B-), followed by 002 (n = 2 isolates) and 014 (n = 2 isolates). The remaining C. difficile isolates were typed as 012 (n = 1), 046 (n = 1), 078 ribotypes (n = 1) and 2 isolates were untypable. In conclusion, after the Pan-European surveillance study, a laboratory-based surveillance of CDI has been introduced in Bulgaria. The most prevalent C. difficile ribotype in Bulgaria was 017 (40%). All determined PCR ribotypes were found to be associated with severe CDI and a high percentage of lethal outcomes, indicating that improvements of surveillance with appropriate clinical and epidemiological criteria is warranted

PREVALENCE OF CLOSTRIDIUM DIFFICILE PCR RIBOTYPES IN BULGARIA, 2008-2010

Clostridium difficile is one of the most important causative agents of severe diarrhoea in hospitalised patients treated with antibiotics. Since 2008, Bulgaria participated in the Pan-European Surveillance Study investigating the prevalence of C. difficile infections (CDI) in different European countries. In the period November 2008 - March 2010, the incidence of CDI in nine participating hospitals was 7.94 per 10 000 patient admissions (0.34 per 10 000 patient-days). In total, sixty five fecal samples from patients with mild to severe enterocolitis and previous antibiotic treatment were investigated for CDI. Strains were typed and further characterized for the presence of toxins A (TcdA), B (TcdB) and binary toxins (CdtA and CdtB). Of 65 stool samples included, 15 were toxin and culture positive for C. difficile. Six of the isolates (40%) belonged to PCR ribotype 017 (TcdA(-).; TcdB(+); CdtA/B-), followed by 002 (n = 2 isolates) and 014 (n = 2 isolates). The remaining C. difficile isolates were typed as 012 (n = 1), 046 (n = 1), 078 ribotypes (n = 1) and 2 isolates were untypable. In conclusion, after the Pan-European surveillance study, a laboratory-based surveillance of CDI has been introduced in Bulgaria. The most prevalent C. difficile ribotype in Bulgaria was 017 (40%). All determined PCR ribotypes were found to be associated with severe CDI and a high percentage of lethal outcomes, indicating that improvements of surveillance with appropriate clinical and epidemiological criteria is warranted.Medical Microbiolog

EUROPEAN CENTRE FOR DISEASE PREVENTION

Nationwide outbreak of STEC O157 infection in the Netherlands, December 2008-January 2009: continuous risk of consuming raw beef products