Characteristics of Clostridium difficile infection in a high complexity hospital and report of the circulation of the NAP1/027 hypervirulent strain in Colombia

Sandra Milena Gualtero, Lina Alejandra Abril, Nathalia Camelo, Susi Daniela Sanchez, Fabián Antonio Davila, Gerson Arias, Edwin Silva, Ingrid Gissel Bustos, Diego Fernando Josa, Isabel Cristina Torres, Luis Carlos Zambrano, María José Pareja, .

Keywords: Clostridium difficile, bacterial infections, anti-infective agents, diarrhea, enterocolitis, pseudomembranous, polymerase chain reaction

Abstract

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.

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  • Sandra Milena Gualtero Grupo de Infectología y Laboratorio, Fundación Clínica Shaio, Bogotá, D.C., Colombia
  • Lina Alejandra Abril Grupo de Infectología y Laboratorio, Fundación Clínica Shaio, Bogotá, D.C., Colombia
  • Nathalia Camelo Grupo de Infectología y Laboratorio, Fundación Clínica Shaio, Bogotá, D.C., Colombia
  • Susi Daniela Sanchez Grupo de Infectología y Laboratorio, Fundación Clínica Shaio, Bogotá, D.C., Colombia
  • Fabián Antonio Davila Grupo de Infectología y Laboratorio, Fundación Clínica Shaio, Bogotá, D.C., Colombia
  • Gerson Arias Grupo de Infectología y Laboratorio, Fundación Clínica Shaio, Bogotá, D.C., Colombia
  • Edwin Silva Grupo de Infectología y Laboratorio, Fundación Clínica Shaio, Bogotá, D.C., Colombia
  • Ingrid Gissel Bustos Grupo de Infectología y Laboratorio, Fundación Clínica Shaio, Bogotá, D.C., Colombia
  • Diego Fernando Josa Grupo de Infectología y Laboratorio, Fundación Clínica Shaio, Bogotá, D.C., Colombia
  • Isabel Cristina Torres Grupo de Infectología y Laboratorio, Fundación Clínica Shaio, Bogotá, D.C., Colombia
  • Luis Carlos Zambrano Grupo de Infectología y Laboratorio, Fundación Clínica Shaio, Bogotá, D.C., Colombia
  • María José Pareja Grupo de Infectología y Laboratorio, Fundación Clínica Shaio, Bogotá, D.C., Colombia

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How to Cite
1.
Gualtero SM, Abril LA, Camelo N, Sanchez SD, Davila FA, Arias G, 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. biomedica [Internet]. 2017 Dec. 1 [cited 2024 May 11];37(4):466-72. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/3244

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Published
2017-12-01
Section
Original articles

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