Abstract

ORREGO-MIRANDA, María Verónica et al. Epidemio-molecular characterization of Clostridioides difficile infection in hospitalized patients with diarrhea in health institutions. 2019. Mem. Inst. Investig. Cienc. Salud [online]. 2023, vol.21, n.1, e21122305.  Epub May 03, 2023. ISSN 1812-9528.  https://doi.org/10.18004/mem.iics/1812-9528/2023.e21122305.

Clostridioides difficile infection is one of the main causes of nosocomial diarrhea in hospitals worldwide, associated with broad-spectrum antibiotics. Descriptive, retrospective, cross-sectional, census-type study. Two hundred eighty-one samples from patients hospitalized with the infection were studied, sociodemographic and clinical characteristics were analyzed and the pathogen was characterized molecularly. As a result, patients with the infection had a median age of 64 years and 61.5% male. The average presentation of diarrhea was 5 days, antimicrobial treatment 8 days and hospitalization 15 days. Ninety four percent had previous antimicrobial treatment, and 6% were exposed to some risk factor. The most commonly used antimicrobials alone or in combination were beta-lactams, fluoroquinolones, vancomycin, and carbapenems. The hospitalization areas with the highest frequency of presentation of the infection were the Clinical Medicine, Traumatology, Geriatrics and Intensive Care Unit units. The prevalence of toxigenic C. difficile was 14%, and of this frequency, 100% presented TcdA and TcdB toxins, with the absence of binary toxins and deletion of the tcdC gene. The presence of clonal groups was verified in the same hospitalization unit and the same health institution. All the strains were susceptible to the antibiotics of choice for the infection. The prevalence of infection and the presence of clonal profiles detected reveal the need for improvement of the infection control system, as well as of the strengthening and surveillance of antimicrobial resistance.

Keywords : Clostridioides difficile; infection; epidemiology; antimicrobials; clonal strains.

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