Sunday December 4, 2005
Epidemic of new fluoroquinolone induce strain of C. Diff.

Centers for Disease Control and Prevention has release a report on epidemic of new fluoroquinolone induce strain of C. Diff. The New England Journal of Medicine has put out 2 reports on epidemic of a new strain of Clostridium difficile on Dec. 8 2005 issue (see in references). It is called BI/NAP1 isloates and showing a lot more resistance to fluoroquinolones (Gatifloxacin and Moxifloxacin). It appears more toxic as canadian report shows 30-day attributable mortality rate of 6.9 percent. Regular laboratory may not be equipped to do the test so you may have to specifically ask for it. Be more vigilant as early treatment is the key and with no response to oral metronidazole, early switch to oral vancomycin may be needed.

Alochol can’t kill C.diff spores so washing with soap and water is required.

Report 1: Georgia, Illinois, Maine, New Jersey, Oregon, and Pennsylvania.
Report 2: 12 hospitals in Quebec, Canada

References:
1. An Epidemic, Toxin Gene–Variant Strain of Clostridium difficile
2. A Predominantly Clonal Multi-Institutional Outbreak of Clostridium difficile–Associated Diarrhea with High Morbidity and Mortality
3. The New Clostridium difficile — What Does It Mean?