Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospital
Braz. j. infect. dis
; 20(1): 8-13, Jan.-Feb. 2016. tab
Artigo
em Inglês
| LILACS
| ID: lil-776470
Biblioteca responsável:
BR1.1
ABSTRACT
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.
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Contexto em Saúde:
Agenda de Saúde Sustentável para as Américas
Problema de saúde:
Objetivo 8: Surtos, emergências e desastres
Base de dados:
LILACS
Assunto principal:
Infecção Hospitalar
/
Surtos de Doenças
/
Clostridioides difficile
/
Infecções por Clostridium
Tipo de estudo:
Estudo de etiologia
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Adolescente
/
Adulto
/
Idoso
/
Feminino
/
Humanos
/
Masculino
País/Região como assunto:
México
Idioma:
Inglês
Revista:
Braz. j. infect. dis
Assunto da revista:
Doenças Transmissíveis
Ano de publicação:
2016
Tipo de documento:
Artigo
País de afiliação:
México
Instituição/País de afiliação:
Hospital Civil de Guadalajara/MX