Clostridium difficile PCR ribotype 027: assessing the risks of further worldwide spread
Clements, A.C., Magalhaes, R.J., Tatem, A.J., Paterson, D.L. and Riley, T.V. (2010) Clostridium difficile PCR ribotype 027: assessing the risks of further worldwide spread. The Lancet Infectious Diseases, 10, (6), 395-404. (doi:10.1016/S1473-3099(10)70080-3). (PMID:20510280).
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Highly virulent strains of Clostridium difficile have emerged since 2003, causing large outbreaks of severe, often fatal, colitis in North America and Europe. In 2008-10, virulent strains spread between continents, with the first reported cases of fluoroquinolone-resistant C difficile PCR ribotype 027 in three Asia-Pacific countries and Central America. We present a risk assessment framework for assessing risks of further worldwide spread of this pathogen. This framework first requires identification of potential vehicles of introduction, including international transfers of hospital patients, international tourism and migration, and trade in livestock, associated commodities, and foodstuffs. It then calls for assessment of the risks of pathogen release, of exposure of individuals if release happens, and of resulting outbreaks. Health departments in countries unaffected by outbreaks should assess the risk of introduction or reintroduction of C difficile PCR ribotype 027 using a structured risk-assessment approach.
|Keywords:||asia, bacterial typing techniques, central america, clostridium difficile, classification, genetics, isolation and purification, disease outbreaks, drug resistance, bacterial enterocolitis, pseudomembranous, epidemiology, microbiology, europe, humans, north america, ribotyping risk assessment|
|Subjects:||H Social Sciences > HA Statistics
Q Science > QR Microbiology > QR180 Immunology
R Medicine > RA Public aspects of medicine
|Divisions:||Faculty of Social and Human Sciences > Geography and Environment
|Date Deposited:||05 Nov 2012 16:38|
|Last Modified:||05 Nov 2012 16:38|
|RDF:||RDF+N-Triples, RDF+N3, RDF+XML, Browse.|
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