RESUMO
In 54/64 subjects with nosocomial diarrhea, fecal calprotectin levels correlated with the results of stool samples tested for Clostridium difficile toxin gene by PCR. Fecal calprotectin levels can be used as an adjunctive measure to PCR to support the diagnosis of C. difficile infection.
Assuntos
Toxinas Bacterianas/genética , Calcitonina/sangue , Clostridioides difficile/genética , Enterocolite Pseudomembranosa/diagnóstico , Enterotoxinas/genética , Complexo Antígeno L1 Leucocitário/metabolismo , Precursores de Proteínas/sangue , Bioensaio , Peptídeo Relacionado com Gene de Calcitonina , Clostridioides difficile/patogenicidade , Creatinina/sangue , Infecção Hospitalar , Enterocolite Pseudomembranosa/microbiologia , Fezes/química , Fezes/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Estudos Prospectivos , Sensibilidade e Especificidade , Albumina Sérica/análiseRESUMO
BACKGROUND: Nonantiseptic bathing practices among inpatients and residents of nursing homes vary in terms of frequency, bathing type and product. We performed a systematic review to compare the efficacy of different bathing practices in reducing skin colonization, health care-associated infections (HAI) or their impact on skin integrity. METHODS: We searched Medline and Embase up until February 2018 testing a combination of terms for 3 concepts: (1) personal hygiene, (2) inpatients, (3) skin colonization, integrity or HAIs. Studies set in ICUs or including children were excluded. This review was registered in PROSPERO: CRD42018091639. RESULTS: Seven studies were included. No statistically significant impact in terms of reduced skin colonization was described irrespective of bathing product, type or frequency except for a reduced burden of C difficile on the skin of infected patients after showering compared to bathing. One study addressing impact on HAI did not detect a significant difference when a waterless no-rinse product was used. Integrity of the skin was better preserved by no-rinse products. CONCLUSIONS: No study described a statistically significant reduction of bacterial skin colonization or incidence of HAI after bathing hospitalized patients with nonantiseptic products. However, waterless no-rinse products were associated with less skin damage in most studies.