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Biomédica

versão impressa ISSN 0120-4157

Resumo

GUALTERO, Sandra Milena et al. Characteristics of Clostridium difficile infection in a high complexity hospital and report of the circulation of the NAP1/027 hypervirulent strain in Colombia. Biomédica [online]. 2017, vol.37, n.4, pp.466-472. ISSN 0120-4157.  http://dx.doi.org/10.7705/biomedica.v34i2.3244.

Introduction: Clostridium difficile

is the main pathogen related to healthcare-associated diarrhea and it is the cause of 20 to 30% of diarrhea cases caused by antibiotics. In Colombia and Latin America, the knowledge about the epidemiological behavior of this infection is limited.

Objective:

To describe the characteristics of a series of patients with C. difficile infection.

Materials and methods:

We performed a descriptive case series study of patients with C. difficile infection hospitalized in the Fundación Clínica Shaio from January, 2012, to November, 2015.

Results:

We analyzed 36 patients. The average age was 65 years. The risk factors associated with the infection were: previous use of antibiotics (94.4%), prior hospitalization in the last three months (66.7%) and use of proton pump inhibitors (50%). The most common comorbidities were chronic kidney disease (41.7%) and diabetes mellitus (30.6%). The most frequent symptoms were more than three loose stools per day (97.1%) and abdominal pain (42.9%). According to the severity of the disease, 44.4% of cases were classified as mild to moderate, 38.9% as severe, and 11.1% as complicated or severe. The detection of the toxin by PCR (GeneXpert) was the most common diagnostic procedure (63.8%). Global mortality during hospitalization was 8%. We identified four strains with serotype NAP1/027 and nine samples positive for binary toxin.

Conclusion: Clostridium difficile

infection should be suspected in patients with diarrhea and traditional risk

factors associated with this disease. We report the circulation of the hypervirulent strain serotype NAP1/027 in Colombia, which should be countered with epidemiological surveillance and a prompt diagnosis.

Palavras-chave : Clostridium difficile; bacterial infections; anti-infective agents; diarrhea; enterocolitis, pseudomembranous; polymerase chain reaction.

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