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Projects / Programmes source: ARIS

Clostridium difficile genotypes associated with diseases in Slovenia

Research activity

Code Science Field Subfield
3.08.00  Medical sciences  Public health (occupational safety)   

Code Science Field
B230  Biomedical sciences  Microbiology, bacteriology, virology, mycology 
Keywords
Clostridium difficile, public health, nosocomial infections, antibiotics, genotyping, intestinal infections
Evaluation (rules)
source: COBISS
Researchers (8)
no. Code Name and surname Research area Role Period No. of publicationsNo. of publications
1.  10981  PhD Milan Čižman  Microbiology and immunology  Researcher  2008 - 2010  452 
2.  30755  PhD Sandra Janežič  Microbiology and immunology  Junior researcher  2010 - 2011  156 
3.  22300  PhD Božena Kotnik Kevorkijan  Microbiology and immunology  Researcher  2008 - 2010  218 
4.  28876  Nadja Orešič  Microbiology and immunology  Researcher  2008 - 2011 
5.  15476  PhD Marko Pokorn  Microbiology and immunology  Researcher  2008 - 2010  307 
6.  10478  Jelka Helena Reberšek-Gorišek  Microbiology and immunology  Researcher  2008 - 2010  405 
7.  12278  PhD Maja Rupnik  Microbiology and immunology  Head  2008 - 2011  689 
8.  11329  PhD Maja Sočan  Public health (occupational safety)  Researcher  2008 - 2010  620 
Organisations (2)
no. Code Research organisation City Registration number No. of publicationsNo. of publications
1.  0312  University Medical Centre Ljubljana  Ljubljana  5057272000  77,925 
2.  0334  University Medical Centre Maribor  Maribor  5054150000  23,094 
Abstract
Clostridium difficile is currently among major causes of hospital-associated infections. The disease can range from self limiting diarrhoea or colitis to life threatening pseudomembranous colitis. The precondition for successful colonization of C. difficile is the disturbance of normal gut flora resulting from previous antibiotic therapy or chemotherapy. By molecular typing methods (ribotyping or pulse field electrophoresis) C. difficile strains can be differentiated into more than 150 genotypes and some of them show increased virulence. Most widespread at the time is genotype BI/NAP1/027, but severe disease can be caused by several other genotypes. Changing epidemiology including increasing morbidity and mortality in populations with previously low risk (younger popultion, patients wizhout previous hospitalization or anibiotic therapy) also needs to be considered. Known and new hypervirulent genotypes have to be recognized and their prevalence in local environment should be monitored for efficient control of C. difficile infections. The objectives of the project are to determine the prevalence of different C. difficile genotypes in Slovenia, their correlation with disease severity, to determine the risk factors in our local environment and to estimate the increased costs linked of C. difficile infections.
Significance for science
Within this project two new molecular methods were developed. One of them is culture indipendent ribotyping that decrease the time to type result from minimal 4 days to 1-2 days. Other is real time PCR for detection of nontoxinogenic C. difficile strains. We expect that both will be of interest for general C. difficile scientific community. Also, within this project microbiological and epidemiological data about C. difficile and C. difficile infection in humans were obtained for the first time for Slovenia. These results will be internationally important for comparative studies and to better understand the spread of certain groups within C. difficile species. Results on colonization of patients at the time of hospitalization are of interest for scientific community as published data are mainly old and do not apply to current situation while recent data are very rare.
Significance for the country
Results obtained within this project have added to understanding of the local situation of C. difficile-associated infections (CDI) that are currently one of the main problems within health care-associated infections in the developed world. For the first time following data for Slovenia are available: prevalence and distribution of ribotypes within two main Slovenian regions and a crude estimate for other regions, data on colonization of the patients at the time of hospitalization, data on the presence of bacteria in the hospital environment and analysis of epidemiological data. One of the main outcomes of this project is also establishment of collaborative network between three main key players involved in the CDI infection control: microbiology lab with expertise on C. difficile biology, infection disease specialists from two largest hospitals and epidemiologist from the National Institute of Public Health. This network was already very usefull in limiting CDI burden. We have started to notice emergence of ribotypes with increased virulence (078, 027) in the year 2010 while they were not present (or extremely rare) in our collection before. At the end of 2010 we recognized the first small outbreak with ribotype 027 and after the end of this project (February-March 2011) another local spread of ribotype 027. Established network proved usefull in rapid reaction to the situation in form of local level control and informing slovenian health care community. Transfer of knowledge was provided through the education of young medical specialists, preparation of graduate research projects and training of PhD student.
Most important scientific results Annual report 2008, 2009, final report, complete report on dLib.si
Most important socioeconomically and culturally relevant results Annual report 2008, 2009, final report, complete report on dLib.si
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