Title |
Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospital
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Published in |
Brazilian Journal of Infectious Diseases, November 2015
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DOI | 10.1016/j.bjid.2015.09.008 |
Pubmed ID | |
Authors |
Rayo Morfin-Otero, Elvira Garza-Gonzalez, Sara A. Aguirre-Diaz, Rodrigo Escobedo-Sanchez, Sergio Esparza-Ahumada, Hector R. Perez-Gomez, Santiago Petersen-Morfin, Esteban Gonzalez-Diaz, Adrian Martinez-Melendez, Eduardo Rodriguez-Noriega, Fray Antonio Alcalde Clostridium difficile Team for the Hospital Civil de Guadalajara |
Abstract |
Clostridium difficile infections caused by the NAP1/B1/027 strain are more severe, difficult to treat, and frequently associated with relapses. A case-control study was designed to examine a C. difficile infection (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). During the study period, 288 adult patients were evaluated and 79 (27.4%) patients had confirmed CDI (PCR positive). C. difficile strain 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. difficile NAP1/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). C. difficile NAP1/BI/027 strain and non-027 strains are established pathogens in our hospital. Accordingly, surveillance of C. difficile infections is now part of our nosocomial prevention program. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 1 | 100% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Practitioners (doctors, other healthcare professionals) | 1 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 74 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 15 | 20% |
Other | 7 | 9% |
Student > Ph. D. Student | 7 | 9% |
Student > Master | 6 | 8% |
Student > Bachelor | 5 | 7% |
Other | 12 | 16% |
Unknown | 22 | 30% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 17 | 23% |
Immunology and Microbiology | 9 | 12% |
Agricultural and Biological Sciences | 4 | 5% |
Biochemistry, Genetics and Molecular Biology | 3 | 4% |
Economics, Econometrics and Finance | 2 | 3% |
Other | 10 | 14% |
Unknown | 29 | 39% |