Healthcare-associated Diarrhea due to Clostridioides difficile in Patients Attending a Tertiary Care Teaching Hospital of North India.

Nikhil Raj, Jyotsna Agarwal, Vikramjeet Singh, Manodeep Sen, Anupam Das
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Abstract

Background: Healthcare-associated diarrhea (HCAD) is diarrhea that develops at least after 3 days of hospitalization, with the most common infectious cause being Clostridioides difficile. Over the last decade, there has been a remarkable growth in the frequency and severity of C. difficile infection (CDI), making it one of the most prevalent healthcare-associated infections. This study aimed to analyze the prevalence and risk factors associated with CDI.

Materials and methods: A total of 107 patients with clinical suspicion of having HCAD were included in this study. Enzyme-linked fluorescent assay (ELFA) technique-based glutamate dehydrogenase (GDH) and toxin A/B assay were used as per the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) for diagnosing CDI. The details about associated comorbidities were retrieved from the hospital information system records. The presence of risk factors was noted. Risk factors associated with CDI were looked for.

Results: Out of the 107 stool samples received in the microbiology laboratory from patients with suspected HCAD eight (7.6%) samples were positive for CDI. The most frequent comorbidity observed in these patients was renal illness (acute or chronic kidney disease). In this study, a total of 7/8 cases were on multiple antibiotics most common being carbapenem.

Conclusion: The 6-year prevalence of CDI observed in this study was found to be 7.6% risk factors, associated with CDI were kidney disease, diabetes mellitus, malignancy, and exposure to broad-spectrum antibiotics.

How to cite this article: Raj N, Agarwal J, Singh V, et al. Healthcare-associated Diarrhea due to Clostridioides difficile in Patients Attending a Tertiary Care Teaching Hospital of North India. Euroasian J Hepato-Gastroenterol 2024;14(1):60-64.

Abstract Image

印度北部一家三级教学医院就诊患者因艰难梭菌引起的医源性腹泻
背景:医疗相关腹泻(HCAD)是指至少在住院 3 天后发生的腹泻,最常见的感染原因是艰难梭菌。在过去十年中,艰难梭菌感染(CDI)的发病率和严重程度显著增加,成为最普遍的医疗相关感染之一。本研究旨在分析与艰难梭菌感染相关的发病率和风险因素:本研究共纳入 107 名临床怀疑患有 HCAD 的患者。根据欧洲临床微生物学和传染病学会(ESCMID)的规定,采用基于酶联荧光测定(ELFA)技术的谷氨酸脱氢酶(GDH)和毒素A/B测定来诊断CDI。从医院信息系统记录中检索了相关合并症的详细信息。注意是否存在风险因素。寻找与 CDI 相关的危险因素:在微生物实验室收到的 107 份疑似 HCAD 患者粪便样本中,有 8 份(7.6%)样本的 CDI 检测结果呈阳性。这些患者中最常见的合并症是肾病(急性或慢性肾病)。在这项研究中,共有 7/8 例患者使用多种抗生素,其中最常见的是碳青霉烯类抗生素:结论:本研究中观察到的 6 年 CDI 患病率为 7.6%,与 CDI 相关的风险因素包括肾脏疾病、糖尿病、恶性肿瘤和接触广谱抗生素:Raj N, Agarwal J, Singh V, et al. 北印度一家三级教学医院就诊患者因艰难梭菌引起的医源性腹泻。Euroasian J Hepato-Gastroenterol 2024;14(1):60-64.
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