Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospital
Morfin-Otero, Rayo; Garza-Gonzalez, Elvira; Aguirre-Diaz, Sara A.; Escobedo-Sanchez, Rodrigo; Esparza-Ahumada, Sergio; Perez-Gomez, Hector R.; Petersen-Morfin, Santiago; Gonzalez-Diaz, Esteban; Martinez-Melendez, Adrian; Rodriguez-Noriega, Eduardo; Hospital Civil de Guadalajara, Fray Antonio Alcalde Clostridium difficile Team.
Braz. j. infect. dis
; 20(1): 8-13, Jan.-Feb. 2016. tab
Artigo
em Inglês
| LILACS | ID: lil-776470
Abstract Background Clostridium difficile infections caused by the NAP1/B1/027 strain are more severe, difficult to treat, and frequently associated with relapses. Methods A case–control study was designed to examine a C. difficileinfection (CDI) outbreak over a 12-month period in a Mexican hospital. The diagnosis of toxigenic CDI was confirmed by real-time polymerase chain reaction, PCR (Cepheid Xpert C. difficile/Epi). Results During the study period, 288 adult patients were evaluated and 79 (27.4%) patients had confirmed CDI (PCR positive). C. difficilestrain NAP1/B1/027 was identified in 31 (39%) of the patients with confirmed CDI (240 controls were included). Significant risk factors for CDI included any underlying disease (p < 0.001), prior hospitalization (p < 0.001), and antibiotic (p < 0.050) or steroid (p < 0.001) use. Laboratory abnormalities included leukocytosis (p < 0.001) and low serum albumin levels (p < 0.002). Attributable mortality was 5%. Relapses occurred in 10% of patients. Risk factors for C. difficileNAP1/B1/027 strain infections included prior use of quinolones (p < 0.03). Risk factors for CDI caused by non-027 strains included chronic cardiac disease (p < 0.05), chronic renal disease (p < 0.009), and elevated serum creatinine levels (p < 0.003). Deaths and relapses were most frequent in the 027 group (10% and 19%, respectively). Conclusions C. difficile NAP1/BI/027 strain and non-027 strains are established pathogens in our hospital. Accordingly, surveillance ofC. difficile infections is now part of our nosocomial prevention program.
Assuntos
Adolescente Adulto Idoso Feminino Humanos Masculino Pessoa de Meia-Idade Adulto Jovem Infecções por Clostridium/epidemiologia Infecções por Clostridium/microbiologia Clostridioides difficile/classificação Infecção Hospitalar/epidemiologia Infecção Hospitalar/microbiologia Surtos de Doenças Técnicas de Tipagem Bacteriana Estudos de Casos e Controles México/epidemiologia Reação em Cadeia da Polimerase em Tempo Real Fatores de Risco Índice de Gravidade de Doença
Biblioteca responsável:
BR1.1
powered by iAHx-2.18-86
Biblioteca Virtual em Saúde do Adolescente