Clostridium difficileInfection (CDI) Severity and Outcome among Patients Infected with the NAP1/BI/027 Strain in a Non-Epidemic Setting

Abstract

In a nonepidemic setting, NAP1 strains were more common in older patients and individuals admitted from nursing homes. Identification of NAP1 by PCR of stool specimens was associated in a change of therapy but did not predict worse outcomes. Reporting strain results may not be clinically useful in routine settings.

The Attributable Burden of Clostridium difficile Infection to Long‐Term Care Facilities Stay: A Clinical Study

“…A possible explanation for the increased severity of CDI and also high frequency of recurrences could be the frequent detection of the hypervirulent strain NAP1/BI/027 in LTCF settings. [41][42][43] The hospital setting was in our study as the most frequent site of management for CDIs of LTCF residents in contrast to community residents, a finding that reiterates indirectly the severity of the disease.…”

Clostridium difficile Infection and Fecal Microbiota Transplant

“…18 Although NAP1 is more common in elderly patients and patients in long-term nursing facilities, some studies have shown a lack of association between NAP1 strains and severe disease. 19 The actual incidence of the NAP1/BI/027 strain varies by geographic region, and testing for the strain is useful for an epidemiologic understanding of CDI, but not for the practical care of an individual.…”

Clinical Utility of Laboratory Detection of Clostridium difficile Strain BI/NAP1/027

“…Although rapid detection of epidemiologically significant pathogens can be particularly useful for infection control programs, data supporting rapid detection of BI/NAP1/027 as an infection control tool are limited. Interestingly, data from a single health care facility utilizing a NAAT that rapidly identifies BI/NAP1/027 suggest that providers more frequently changed antibiotic therapy from metronidazole alone to vancomycin plus intravenous metronidazole when BI/NAP1/027 was identified (31). This treatment combination is recommended for severe, complicated CDI (also called fulminant CDI) rather than for CDI caused by a specific strain type.…”