Clostridium difficile and antibiotic associated diarrhoea in Sweden. 1982

B Aronsson, and R Möllby, and C E Nord

Distribution of age and sex among patients with Clostridium difficile enterocolitis shows an increased ratio female: male (3:1) in age group 20 to 40 years and a corresponding 2:1 ratio in patients over 70 years of age, the latter group constituting 45% of 505 patients investigated. Being the only laboratory in Sweden performing cytotoxin-assay from cases of C. difficile enterocolitis during 1979-1981, we have observed that the frequencies with which clindamycin/lincomycin are associated with C. difficile enterocolitis have decreased from 30% (1979) to 9% (1981) while the role of cephalosporins has increased from 18% to 29%. Corresponding figures for the penicillins are 31% and 47% for the respective years. Against a background of sales statistics of these antibiotics in Sweden the risk of contracting C. difficile enterocolitis is appreciated for clindamycin/lincomycin and the cephalosporins in comparison to that of the penicillins. These calculations yielded a 63 times greater risk for clindamycin/lincomycin and a 36 times greater risk for the cephalosporins compared to that of penicillins. The susceptibility patterns of 96 clinical isolates of C. difficile are given showing an increased resistance to ceftriaxon, cephalotin, cefoperazone, cefoxitin and moxalactam, as compared to the susceptibility to other antibiotics. The cytotoxin and the enterotoxin produced by C. difficile are described. In our hands the enterotoxin causes hemorrhagic fluid accumulation and gross mucosal damage to rabbit ileal mucosa while the cytotoxin causes only mild inflammatory changes. It is pointed out that the assay demonstrating toxin in cases of C. difficile enterocolitis currently used in practise only measures the presence of cytotoxin and that a routine method for demonstration of enterotoxin is lacking to date.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008034 Lincomycin An antibiotic produced by Streptomyces lincolnensis var. lincolnensis. It has been used in the treatment of staphylococcal, streptococcal, and Bacteroides fragilis infections. Lincolnensin,Lincomycin, (2S-cis)-Isomer,Epilincomycin,Lincocin,Lincomycin A,Lincomycin Hydrochloride,Lincomycin Monohydrochloride,Lincomycin Monohydrochloride, (2S-cis)-Isomer,Lincomycin Monohydrochloride, (L-threo)-Isomer,Lincomycin Monohydrochloride, Hemihydrate,Lincomycin, (L-threo)-Isomer,Hemihydrate Lincomycin Monohydrochloride
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010403 Penicillin Resistance Nonsusceptibility of an organism to the action of penicillins. Penicillin Resistances,Resistance, Penicillin,Resistances, Penicillin
D010406 Penicillins A group of antibiotics that contain 6-aminopenicillanic acid with a side chain attached to the 6-amino group. The penicillin nucleus is the chief structural requirement for biological activity. The side-chain structure determines many of the antibacterial and pharmacological characteristics. (Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed, p1065) Antibiotics, Penicillin,Penicillin,Penicillin Antibiotics
D002511 Cephalosporins A group of broad-spectrum antibiotics first isolated from the Mediterranean fungus ACREMONIUM. They contain the beta-lactam moiety thia-azabicyclo-octenecarboxylic acid also called 7-aminocephalosporanic acid. Antibiotics, Cephalosporin,Cephalosporanic Acid,Cephalosporin,Cephalosporin Antibiotic,Cephalosporanic Acids,Acid, Cephalosporanic,Acids, Cephalosporanic,Antibiotic, Cephalosporin,Cephalosporin Antibiotics
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D002981 Clindamycin An antibacterial agent that is a semisynthetic analog of LINCOMYCIN. 7-Chloro-7-deoxylincomycin,Chlolincocin,Chlorlincocin,Cleocin,Clindamycin Hydrochloride,Clindamycin Monohydrochloride,Clindamycin Monohydrochloride, Monohydrate,Dalacin C,7 Chloro 7 deoxylincomycin,Hydrochloride, Clindamycin,Monohydrate Clindamycin Monohydrochloride,Monohydrochloride, Clindamycin,Monohydrochloride, Monohydrate Clindamycin

Related Publications

B Aronsson, and R Möllby, and C E Nord
June 2018, Clinical medicine (London, England),
B Aronsson, and R Möllby, and C E Nord
July 2000, Age and ageing,
B Aronsson, and R Möllby, and C E Nord
October 2003, Best practice & research. Clinical gastroenterology,
B Aronsson, and R Möllby, and C E Nord
April 2003, Alimentary pharmacology & therapeutics,
B Aronsson, and R Möllby, and C E Nord
March 2017, The Cochrane database of systematic reviews,
B Aronsson, and R Möllby, and C E Nord
November 1998, Postgraduate medical journal,
B Aronsson, and R Möllby, and C E Nord
March 1985, The Journal of infection,
B Aronsson, and R Möllby, and C E Nord
August 2007, Internal medicine journal,
B Aronsson, and R Möllby, and C E Nord
March 1984, The Journal of infection,
B Aronsson, and R Möllby, and C E Nord
June 2001, The Journal of hospital infection,
Copied contents to your clipboard!