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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.
AuthorsJamie S Huang, Zhi-Dong Jiang, Kevin W Garey, Todd Lasco, Herbert L Dupont
JournalAntimicrobial agents and chemotherapy (Antimicrob Agents Chemother) Vol. 57 Issue 6 Pg. 2690-3 (Jun 2013) ISSN: 1098-6596 [Electronic] United States
PMID23545528 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
Chemical References
  • Anti-Bacterial Agents
  • Rifamycins
Topics
  • Aged
  • Anti-Bacterial Agents (pharmacology, therapeutic use)
  • Case-Control Studies
  • Clostridioides difficile (drug effects)
  • Cross Infection (drug therapy, epidemiology, microbiology)
  • Drug Resistance, Bacterial
  • Enterocolitis, Pseudomembranous (drug therapy, epidemiology, microbiology)
  • Female
  • Hospitals, University (statistics & numerical data)
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Rifamycins (pharmacology, therapeutic use)
  • Risk Factors
  • Texas (epidemiology)

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