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Memorias del Instituto de Investigaciones en Ciencias de la Salud

On-line version ISSN 1812-9528

Abstract

ORREGO, María; WEILER, Natalie  and  MARTINEZ, Mario. Detection of toxigenic Clostridioides difficile from diarrheic samples by polymerase chain reaction in hospitalized patients in Paraguay. Period 2016-2018. Mem. Inst. Investig. Cienc. Salud [online]. 2020, vol.18, n.1, pp.55-60. ISSN 1812-9528.  https://doi.org/10.18004/mem.iics/1812-9528/2020.018.01.55-060.

Clostridioides difficile infection is considered the main diarrheal disease associated with patients hospitalized in health institutions, older than 61 years and the use of extended spectrum antimicrobials. It is a strict anaerobic, sporulated gram-positive bacillus. The alteration of the colonic microbiota by antimicrobial treatment allows colonization and infection by this microorganism, whose clinical manifestation is based on the presentation of the diarrheal syndrome. The objective of this study was to detect toxigenic C. difficile from diarrheal samples by polymerase chain reaction in hospitalized patients. This was a descriptive, cross-sectional, prospective study in which an epidemiological record containing the study variables and informed consent were used. In 901 diarrheal samples, tcdA, tcdB, ctdA, ctdB and tcdC toxins and the species gene were detected. The prevalence of toxigenic C. difficile was 19.7% (n=178) of the samples, positives for one or both toxins (toxins A and B) while 98% presented both toxins. A higher frequency of ICD was observed in male patients (52%) who had a median age of 68 years. Antimicrobial treatment and use of antimicrobials were evaluated, where the use of clindamycin, cephalosporins, fluoroquinolones and vancomycin had statistically significant values. The results allowed infection by this pathogen to be epidemiologically characterized. It is very important to make early diagnosis and design and implement strategies to prevent the emergence of this pathogen.

Keywords : detection; Clostridioides difficile; toxins; risk factors.

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