title: Clostridium difficile in Crete, Greece: epidemiology, microbiology and clinical disease.
abstract: We studied the epidemiology and microbiology of Clostridium difficile and the characteristics of patients with C. difficile infection (CDI) in Crete in three groups of hospitalized patients with diarrhoea: group 1 [positive culture and positive toxin by enzyme immunoassay (EIA)]; group 2 (positive culture, negative toxin); group 3 (negative culture, negative toxin). Patients in group 1 were designated as those with definitive CDI (20 patients for whom data was available) and matched with cases in group 2 (40 patients) and group 3 (40 patients). C. difficile grew from 6% (263/4379) of stool specimens; 14·4% of these had positive EIA, of which 3% were resistant to metronidazole. Three isolates had decreased vancomycin susceptibility. Patients in groups 1 and 2 received more antibiotics (P = 0·03) and had more infectious episodes (P = 0·03) than patients in group 3 prior to diarrhoea. Antibiotic administration for C. difficile did not differ between groups 1 and 2. Mortality was similar in all three groups (10%, 12·5% and 5%, P = 0·49). CDI frequency was low in the University Hospital of Crete and isolates were susceptible to metronidazole and vancomycin.
authors.affiliation: Department of Internal Medicine,University of Crete,Heraklion,Greece.
authors.forename: G
authors.initials: G
authors.lastname: Samonis
authors.affiliation: Alfa Institute of Biomedical Sciences (AIBS),Athens,Greece.
authors.forename: K Z
authors.initials: KZ
authors.lastname: Vardakas
authors.affiliation: Alfa Institute of Biomedical Sciences (AIBS),Athens,Greece.
authors.forename: G S
authors.initials: GS
authors.lastname: Tansarli
authors.affiliation: Department of Internal Medicine,University of Crete,Heraklion,Greece.
authors.forename: D
authors.initials: D
authors.lastname: Dimopoulou
authors.affiliation: Department of Internal Medicine,University of Crete,Heraklion,Greece.
authors.forename: G
authors.initials: G
authors.lastname: Papadimitriou
authors.affiliation: Department of Internal Medicine,University of Crete,Heraklion,Greece.
authors.forename: D P
authors.initials: DP
authors.lastname: Kofteridis
authors.affiliation: Department of Clinical Microbiology,University Hospital of Heraklion,Heraklion,Crete,Greece.
authors.forename: S
authors.initials: S
authors.lastname: Maraki
authors.affiliation: Department of Applied Mathematics and Physics,National Technical University of Athens,Athens,Greece.
authors.forename: M
authors.initials: M
authors.lastname: Karanika
authors.affiliation: Alfa Institute of Biomedical Sciences (AIBS),Athens,Greece.
authors.forename: M E
authors.initials: ME
authors.lastname: Falagas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000494:pharmacology / Q000627:therapeutic use; D016360:Clostridioides difficile / Q000187:drug effects / Q000302:isolation & purification / Q000502:physiology*; D003015:Clostridium Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology* / Q000473:pathology; D003967:Diarrhea / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents
keywords: C. difficile mortality; C. difficile resistance; C. difficile susceptibility; C. difficile toxin; C. difficile-associated diarrhoea