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Prevention and therapy of recurrent Clostridioides difficile infection
Polívková, Sylvia ; Beneš, Jiří (advisor) ; Krbková, Lenka (referee) ; Rožnovský, Luděk (referee)
Introduction: Clostridioides difficile infection (CDI) is the most common nosocomial gastrointestinal infection, it is associated with antibiotic use and due to the spread of epidemic strains of C. difficile, there are differences in the course and severity of the disease. This study aimed to describe the characteristics of patients with CDI, to perform molecular analysis of isolates , and then to correlate CDI course and treatment outcomes with the causative ribotypes. Furthermore, the efficacy of antibiotic regimens in the treatment of CDI was evaluated with the severity and number of CDI episodes. Methods: The observational cohort study was conducted in 2013-2016 at the Department of Infectious Diseases of the Bulovka University Hospital in Prague. Patients with laboratory-confirmed CDI were included in the study. C. difficile isolates were characterized by ribotyping, multiple variable tandem repeat analysis (MLVA) and examination of antibiotic resistance determinants (mutations in gyrA, gyrB, rpoB genes or the presence of ermB). Univariate logistic regression was used to evaluate the efficacy of antibiotic regimens (metronidazole, vancomycin, combination of vancomycin and metronidazole, fidaxomicin). Subgroup analyses were performed based on the number and severity of CDI episodes. Results: A...
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