RESUMEN
Community-acquired Clostridium difficile infection (CA-CDI) is a growing concern. CA-CDI differs from hospital-acquired C. difficile infection (HA-CDI) in its epidemiology, risk factors, severity, and outcomes. In this study, we investigated C. difficile infections in a tertiary care hospital in Seoul, Korea, and compared the CA-CDI and HA-CDI cases diagnosed in the same period. Total 593 cases were confirmed as CDI in 2014, of which CA-CDI accounted for 68 (11.5%) of the total CDI cases. Compared with HA-CDI, the mean age of CA-CDI cases was lower than that of HA-CDI (42.7 vs 60.4). In CA-CDI, antibiotic and proton pump inhibitor (PPI) use in the 12 preceding weeks and concurrent chemotherapy and tube feeding were less frequent compared with HA-CDI. In most cases (63/68, 92.6%), patients with CA-CDI recovered without any complications or recurrence. The most prevalent C. difficile type in CA-CDI cases was PCR-ribotype 012, accounting for 18.3% of the total, followed by PCR-ribotype 018 (16.7%).
Asunto(s)
Clostridioides difficile/genética , Infecciones por Clostridium/epidemiología , Infecciones Comunitarias Adquiridas/epidemiología , Infección Hospitalaria/epidemiología , Adulto , Antibacterianos/uso terapéutico , Infecciones por Clostridium/tratamiento farmacológico , Infecciones por Clostridium/microbiología , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Infecciones Comunitarias Adquiridas/microbiología , Infección Hospitalaria/tratamiento farmacológico , Infección Hospitalaria/microbiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , República de Corea/epidemiología , RibotipificaciónRESUMEN
Detection of carbapenemase-producing Enterobacteriaceae (CPE) has become critical for appropriate antimicrobial therapy and for controlling the spread of infection. We evaluated Triton Hodge test (THT) for screening CPE. A spreader can be used to apply more constant volume of Triton on whole surface of Mueller-Hinton agar (MHA), or alternatively, a 10-µL inoculating loop can be used to apply a 20% Triton solution lineally. The THT procedure can be simplified by eliminating the 1/10 dilution step of indicator bacteria from the McFarland 0.5 turbidity suspension. The presence of Triton in the MHA plates significantly increased the enhanced growth size of not only Enterobacteriaceae producing NDM-1-like enzymes but also those producing the most prevalent KPC-2-like enzyme, resulting in 100% sensitivity of the test.