Imperial College London
Alternate

DrXavierDidelot

Faculty of Medicine, School of Public Health

Visiting Professor
 
 
 
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Contact

 

+44 (0)20 7594 3622x.didelot

 
 
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Location

 

G30Medical SchoolSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Dingle:2017:10.1016/S1473-3099(16)30514-X,
author = {Dingle, KE and Didelot, X and Quan, TP and Eyre, DW and Stoesser, N and Golubchik, T and Harding, RM and Wilson, DJ and Griffiths, D and Vaughan, A and Finney, JM and Wyllie, DH and Oakley, SJ and Fawley, WN and Freeman, J and Morris, K and Martin, J and Howard, P and Gorbach, S and Goldstein, EJC and Citron, DM and Hopkins, S and Hope, R and Johnson, AP and Wilcox, MH and Peto, TEA and Walker, AS and Crook, DW},
doi = {10.1016/S1473-3099(16)30514-X},
journal = {LANCET INFECTIOUS DISEASES},
pages = {411--421},
title = {Effects of control interventions on Clostridium difficile infection in England: an observational study},
url = {http://dx.doi.org/10.1016/S1473-3099(16)30514-X},
volume = {17},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background:The control of Clostridium difficile infections is an international clinical challenge. The incidence of C difficile in England declined by roughly 80% after 2006, following the implementation of national control policies; we tested two hypotheses to investigate their role in this decline. First, if C difficile infection declines in England were driven by reductions in use of particular antibiotics, then incidence of C difficile infections caused by resistant isolates should decline faster than that caused by susceptible isolates across multiple genotypes. Second, if C difficile infection declines were driven by improvements in hospital infection control, then transmitted (secondary) cases should decline regardless of susceptibility.Methods:Regional (Oxfordshire and Leeds, UK) and national data for the incidence of C difficile infections and antimicrobial prescribing data (1998–2014) were combined with whole genome sequences from 4045 national and international C difficile isolates. Genotype (multilocus sequence type) and fluoroquinolone susceptibility were determined from whole genome sequences. The incidence of C difficile infections caused by fluoroquinolone-resistant and fluoroquinolone-susceptible isolates was estimated with negative-binomial regression, overall and per genotype. Selection and transmission were investigated with phylogenetic analyses.Findings:National fluoroquinolone and cephalosporin prescribing correlated highly with incidence of C difficile infections (cross-correlations >0·88), by contrast with total antibiotic prescribing (cross-correlations <0·59). Regionally, C difficile decline was driven by elimination of fluoroquinolone-resistant isolates (approximately 67% of Oxfordshire infections in September, 2006, falling to approximately 3% in February, 2013; annual incidence rate ratio 0·52, 95% CI 0·48–0·56 vs fluoroquinolone-susceptible isolates: 1·02, 0·97–1&
AU  - Dingle,KE
AU  - Didelot,X
AU  - Quan,TP
AU  - Eyre,DW
AU  - Stoesser,N
AU  - Golubchik,T
AU  - Harding,RM
AU  - Wilson,DJ
AU  - Griffiths,D
AU  - Vaughan,A
AU  - Finney,JM
AU  - Wyllie,DH
AU  - Oakley,SJ
AU  - Fawley,WN
AU  - Freeman,J
AU  - Morris,K
AU  - Martin,J
AU  - Howard,P
AU  - Gorbach,S
AU  - Goldstein,EJC
AU  - Citron,DM
AU  - Hopkins,S
AU  - Hope,R
AU  - Johnson,AP
AU  - Wilcox,MH
AU  - Peto,TEA
AU  - Walker,AS
AU  - Crook,DW
DO  - 10.1016/S1473-3099(16)30514-X
EP  - 421
PY  - 2017///
SN  - 1473-3099
SP  - 411
TI  - Effects of control interventions on Clostridium difficile infection in England: an observational study
T2  - LANCET INFECTIOUS DISEASES
UR  - http://dx.doi.org/10.1016/S1473-3099(16)30514-X
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000396992300035&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/47955
VL  - 17
ER  -
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