Weiss Karl, Bergeron Luc, Bernatchez Harold, Goyette Monique, Savoie Michel, Thirion Daniel
Maisonneuve-Rosemont Hospital, Faculty of Medicine, University of Montreal, 5415 L'Assomption, Montreal, QC, Canada H1T 2M4.
Int J Antimicrob Agents. 2007 Oct;30(4):309-14. doi: 10.1016/j.ijantimicag.2007.05.020. Epub 2007 Jul 20.
A massive outbreak of a new Clostridium difficile clone affected the province of Quebec between 2002 and 2004. There are several theories as to the exact cause of the emergence of this new clone, including the overuse of some classes of antibiotics. Antibiotic prescription is associated with C. difficile-associated diarrhoea (CDAD), but which class has the highest risk is still the subject of debate. We analysed the global antibiotic consumption patterns in five institutions in Quebec, three in the area affected by the 2002-2004 CDAD outbreak and two in non-affected areas. We showed that there is no correlation between the type and amount of antibiotics used at the institution level and the magnitude of the outbreak. Deficient infection control measures likely led to the rapid spread and dissemination of this newly characterised clone within some parts of Quebec.
2002年至2004年间，一种新型艰难梭菌克隆在魁北克省大规模爆发。关于这种新克隆出现的确切原因有几种理论，包括某些类抗生素的过度使用。抗生素处方与艰难梭菌相关性腹泻（CDAD）有关，但哪一类抗生素风险最高仍存在争议。我们分析了魁北克五家机构的全球抗生素消费模式，其中三家位于2002 - 2004年CDAD爆发影响的地区，两家位于未受影响地区。我们发现，机构层面使用的抗生素类型和数量与爆发规模之间没有相关性。感染控制措施不足可能导致这种新特征的克隆在魁北克的某些地区迅速传播。
