Outbreak of Clostridium difficile-associated disease in Luxembourg

Abstract number: P1491

Staub T., Sakka C., Arendt V., Schmit J., Kirpach P., Hussenet F., Henache F., Schneider F., Hemmer R.

Since 2003 outbreaks of Clostridium difficile associated disease (CDAD) have been recognised in Canada and United States and thereafter in Europe. These outbreaks are caused by a new ribotype called PCR 027.

During the summer 2006 we noticed an increase of the number of cases of CDAD in our hospital. At that time stool culture was not performed, stools were tested for antigen and toxins A and B. After the first of September 2006 stools were cultured to isolate CD and ribotyping was done by a central laboratory. Between the 1st of September 2006 and the 31st of August 2007 106 cases of CDAD were identified. The mean age was 63, there were 53 men and 53 women. Eighty-one strains were isolated from diarrheic patients with suspected CDAD, 27 strains were ribotype 027. Sixteen patients died from CDAD or underlying disease, seven infected with CD 027.

CD ribotype 027 has reached Luxembourg probably in winter or spring 2006 and has spread rapidly causing a large outbreak in our hospital. Mesures have been taken to avoid the spread from patient to patient with reinforcing the isolating procedures.