AI Article Synopsis
- Antibiotic exposure, particularly to fluoroquinolones and macrolides, increases the risk of developing Clostridioides difficile infection (CDI) and leads to a higher chance of isolating antibiotic-resistant strains.
- A study conducted from 2011 to 2021 analyzed 510 CDI patients and found that 66.5% of C. difficile isolates had resistance, with notable odds ratios linked to specific antibiotic classes.
- Despite the high rate of resistance associated with certain antibiotics, the study found no significant differences in clinical outcomes such as relapse or death between patients with resistance and those without.
Article Abstract
Background: Antibiotic exposure is a known risk factor for Clostridioides difficile infection (CDI) and recurrence and can lead to infection with specific C. difficile strains. In this study, we sought to explore the relationship between antecedent antibiotic exposure and C. difficile antimicrobial resistance, and the impact of resistance on clinical outcomes.
Methods: This was a single center retrospective study evaluating patients with CDI between 2011 and 2021. A logistic regression model was used to evaluate the relationship between antecedent antibiotics in the 30 days prior to CDI and resistance among isolates. In addition, an exploratory analysis using a cause-specific Cox proportional hazards model evaluated the association between resistance and a composite outcome of clinical failure, relapse at 30 days or CDI-related death.
Results: we analyzed one isolate from 510 patients; resistance was noted in 339 (66.5 %) of the isolates. Exposure to fluoroquinolones and macrolides was associated with 2.4 (95 % CI 1.4-4.4) and 4.7 (95 % CI 1.1-20.5) increased odds of having resistance compared to other antibiotic class exposure, respectively. There were 58 (17.0 %) patients in the resistance group who developed the composite outcome and 24 (14.2 %) patients who lacked resistance who developed the composite outcome (HR 1.32, 95 % CI 0.81-2.14).
Conclusion: These findings suggest that fluoroquinolone and macrolide exposure were significantly associated with isolating a resistant strain, but we did not find significant differences in clinical outcomes based on the presence of antimicrobial resistance.
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| http://dx.doi.org/10.1016/j.anaerobe.2024.102894 | DOI Listing |
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