• Melina Kachrimanidou, Olga Tsachouridou, Ioannis A Ziogas, Eirini Christaki, Efthymia Protonotariou, Symeon Metallidis, Lemonia Skoura, and Ed Kuijper.
• First Department of Microbiology, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece.
• J. Med. Microbiol. 2017 Dec 1; 66 (12): 1774-1781.

PurposeData regarding the incidence and molecular epidemiology of Clostridium difficile infections (CDIs) in Greece are limited.MethodologyA retrospective study of all laboratory-confirmed CDI cases in a university hospital during a 9-month period. Stool samples from inpatients with diarrhoea were tested with a combined glutamate dehydrogenase (GDH) and toxin enzyme immunoassay (EIA) test, as part of a two-step algorithm for CDI testing. All GDH-positive samples were cultured and isolates were further tested for the presence of toxin genes and characterized by PCR ribotyping.ResultsThe incidence of CDI in our hospital was 25 per 10 000 hospital admissions. Of 33 CDI cases, 72.7 % were hospital-acquired. Fourteen different PCR ribotypes were identified, of which 017 (21.2 %), 078/126 (15.1 %) and RT202 and RT106 (9 %) were the most prevalent. Most patients had a risk profile of recent antibiotic use, older age and comorbidities. Despite mild CDI clinical characteristics, six cases showed complications and led to 18.2 % mortality.ConclusionThe CDI incidence was comparable to that in other European countries. The hypervirulent PCR ribotype 027 was not found, whereas ribotypes 017 and 126 predominated. Most CDI cases were in patients who used antibiotics, emphasizing that antimicrobial stewardship should be considered as a cornerstone for the prevention of CDI.

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