TABLE 1.
Clinical and biological data of the six patients harbouring A−B−CDT+ strains
| Patient no. | Diagnostic | Toxinotype | Date of admission (dd/mm/yy) | Sampling date (dd/mm/yy) | Age (years) | Gender | Ward/hospital | Location (city) | Main reason for admission | White blood cell count | Origin of diarrhoea | Type of diarrhoea | Salmonella, Shigella, Campylobacter, Yersinia | Previous antibiotics | Specific treatment for CDI | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | B−CDT+ (Xpert C. difficile Assay, Cepheid) | XIa | 02/12/2011 | 29/12/2011 | 70 | Male | Vascular surgery/Hôpital Henri Mondor | Créteil (North of France) | Surgical site infection after aortobifemoral prosthetic bypass | 7.8 × 109/L | HC-CDI | Watery | Absent | Imipenem, gentamicin | MTZ po, 500 mg 3 times a day | Diarrhoea resolved/no recurrence |
| 2 | B−CDT+(Xpert C. difficile Assay, Cepheid) | XIb | 05/10/2012 | 07/10/2012 | 81 | Female | Emergency and internal medicine, infectious disease/Hôpital André Mignot | Versailles (North of France) | Pneumonia | 2.9 × 109/L | HC-CDI | Watery and mucoid | Absent | Piperacillin and tazobactam | MTZ po 500 mg 3 times a day | Diarrhoea resolved/no recurrence |
| 3 | A−B−CDT+ (NRC, PCR on colonies) | XIa | 27/11/2012 | 03/12/2012 | 89 | Male | Long-term care/Hôpital de Bourg-en-Bresse | Bourg-en-Bresse (Centre of France) | Vomiting and repetitive falls, pneumonia | 6.4 × 109/L | HC-CDI | Bloody | Absent | Amoxicillin and clavulanic acid | No∗ (symptomatic treatment for diarrhoea) | Diarrhoea resolved |
| 4 | A−B−CDT+ (NRC, PCR on colonies) | XIb | 03/11/2012 | 04/12/2012 | 56 | Male | Nephrology/Hôpital Pellegrin | Bordeaux (South of France) | Acute renal failure and pneumonia | 13 × 109/L | HC-CDI | PMC | ND | Amoxicillin and clavulanic acid | MTZ po 250 mg 3 times a day | Diarrhoea resolved |
| 5 | B−CDT+ (Xpert C. difficile Assay, Cepheid) | XIa | 04/02/2013 | 05/02/2013 | 44 | Male | Hematology/Institut Paoli Calmette | Marseille (South of France) | Febrile diarrhoea | 25 × 109/L | CO-HC-CDI | Unknown | ND | Ticarcillin and clavulanic acid (+cancer chemotherapy) | MTZ po 500 mg 3 times a day | Death not related to CDI |
| 6 | A−B−CDT+ (prevalence study) | XIb | 10/09/2012 | 18/09/2012 | 73 | Male | Hepatologygastroenterology/Hôpital Saint Antoine | Paris (North of France) | Worsening of general conditions with hepatocellular carcinoma | 5.2 × 109/L | HC-CDI | Unknown | Absent | Unknown | No | Death not related to CDI |
ND, not done; HC, health care associated; CDI, C. difficile infection; CO, community onset; PMC, pseudomembranous colitis; MTZ, metronidazole; NRC, national reference centre.
∗
Clostridium difficile has been isolated only by the NRC during EUropean, multicentre, prospective biannual point prevalence study of Clostridium difficile Infection in hospitalized patients with Diarrhoea Euclid study. C. difficile testing had not been requested by the physician nor done by the laboratory. Because this study was noninterventional, the result was not immediately transmitted to the physician.