title: Use of rifamycin drugs and development of infection by rifamycin-resistant strains of Clostridium difficile.
abstract: The relationship between rifamycin drug use and the development of resistant strains of Clostridium difficile was studied at a large university hospital in Houston, TX, between May 2007 and September 2011. In 49 of 283 (17.3%) patients with C. difficile infection (CDI), a rifamycin-resistant strain of C. difficile was identified that compares to a rate of 8% using the same definitions in 2006-2007 (P = 0.59). The 49 patients infected by a resistant organism were matched by date of admission to 98 control patients with CDI from whom a rifamycin-susceptible C. difficile strain was isolated. Cases and controls did not differ according to demographic and clinical characteristics and showed similar but low rates of prior rifamycin use. Similar rates of rifamycin resistance were seen in cases of hospital-acquired CDI (38/112 [34%]) versus community-acquired CDI (7/20 [35%]). At a university hospital in which rifaximin was commonly used, infection by rifamycin-resistant strains of C. difficile was not shown to relate to prior use of a rifamycin drug or to acquiring the infection in the hospital, although the rate of overall resistance appeared to be rising.
authors.affiliation: University of Texas-Houston, School of Public Health, Houston, Texas, USA.
authors.forename: Jamie S
authors.initials: JS
authors.lastname: Huang
authors.forename: Zhi-Dong
authors.initials: ZD
authors.lastname: Jiang
authors.forename: Kevin W
authors.initials: KW
authors.lastname: Garey
authors.forename: Todd
authors.initials: T
authors.lastname: Lasco
authors.forename: Herbert L
authors.initials: HL
authors.lastname: Dupont
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D016022:Case-Control Studies; D016360:Clostridioides difficile / Q000187:drug effects*; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D004761:Enterocolitis, Pseudomembranous / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012294:Rifamycins / Q000494:pharmacology / Q000627:therapeutic use*; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D012294:Rifamycins
references.citation: Antimicrob Agents Chemother. 2008 Aug;52(8):2813-7
references.pmid: 18559647
references.citation: Antimicrob Agents Chemother. 2006 Mar;50(3):827-34
references.pmid: 16495239
references.citation: Drugs. 2010 Jun 18;70(9):1131-48
references.pmid: 20518580
references.citation: J Clin Pathol. 2010 Apr;63(4):355-8
references.pmid: 20354207
references.citation: Lancet. 1993 Mar 13;341(8846):647-50
references.pmid: 8095569
references.citation: J Mol Biol. 1988 Jul 5;202(1):45-58
references.pmid: 3050121
references.citation: Clin Infect Dis. 2009 Feb 15;48(4):425-9
references.pmid: 19140738
references.citation: N Engl J Med. 2010 Mar 25;362(12):1071-81
references.pmid: 20335583
references.citation: N Engl J Med. 2011 Jan 6;364(1):22-32
references.pmid: 21208106
references.citation: Antimicrob Agents Chemother. 2007 Aug;51(8):2716-9
references.pmid: 17517836
references.citation: Clin Infect Dis. 2001 Dec 1;33(11):1807-15
references.pmid: 11692292
references.citation: Ann Intern Med. 1976 Jul;85(1):82-6
references.pmid: 937928
references.citation: J Med Microbiol. 2011 Aug;60(Pt 8):1206-1212
references.pmid: 21292853
references.citation: Aliment Pharmacol Ther. 2013 Jan;37(1):122-8
references.pmid: 23095030
references.citation: Antimicrob Agents Chemother. 2003 Jul;47(7):2316-8
references.pmid: 12821487
references.citation: Infect Control Hosp Epidemiol. 2010 May;31(5):431-55
references.pmid: 20307191
references.citation: JAMA. 2007 Oct 17;298(15):1763-71
references.pmid: 17940231