<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1812-9528</journal-id>
<journal-title><![CDATA[Memorias del Instituto de Investigaciones en Ciencias de la Salud]]></journal-title>
<abbrev-journal-title><![CDATA[Mem. Inst. Investig. Cienc. Salud]]></abbrev-journal-title>
<issn>1812-9528</issn>
<publisher>
<publisher-name><![CDATA[Instituto de Investigaciones en Ciencias de la Salud]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1812-95282023000100005</article-id>
<article-id pub-id-type="doi">10.18004/mem.iics/1812-9528/2023.e21122305</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Caracterización epidemio-molecular de la infección por Clostridioides difficile en pacientes hospitalizados con cuadro diarreico en instituciones de salud. 2019]]></article-title>
<article-title xml:lang="en"><![CDATA[Epidemio-molecular characterization of Clostridioides difficile infection in hospitalized patients with diarrhea in health institutions. 2019]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Orrego-Miranda]]></surname>
<given-names><![CDATA[María Verónica]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Weiler]]></surname>
<given-names><![CDATA[Natalie]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez-Mora]]></surname>
<given-names><![CDATA[Mario]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Kawabata]]></surname>
<given-names><![CDATA[Aníbal]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bogado]]></surname>
<given-names><![CDATA[María Enilda]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[López-Mora]]></surname>
<given-names><![CDATA[Evelyn Rosa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Ministerio de Salud Pública y Bienestar Social Laboratorio Central de Salud Pública ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Ministerio de Salud Pública y Bienestar Social Hospital de Trauma ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto de Previsión Social  ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Ministerio de Salud Pública y Bienestar Social Hospital de Itauguá ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<volume>21</volume>
<numero>1</numero>
<fpage>5</fpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S1812-95282023000100005&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S1812-95282023000100005&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S1812-95282023000100005&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN La infección por Clostridioides difficile es una de las principales causas de diarrea nosocomial en hospitales del mundo, asociada a antibióticos de amplio espectro. Estudio descriptivo, retrospectivo, de corte transverso, de tipo censal. Se estudiaron 281 muestras de pacientes hospitalizados con la infección, se analizaron características socio-demográficas, clínicas y se caracterizó molecularmente al patógeno. Como resultado, se obtuvieron pacientes con la infección con una mediana de edad de 64 años siendo el 61,5 % del sexo masculino. El promedio de presentación del cuadro diarreico fue de 5 días, con tratamiento antimicrobiano de 8 días e internación de 15 días. El 94% tuvo tratamiento antimicrobiano previo, y el 6% estuvo expuesto a algún factor de riesgo. Los antimicrobianos más utilizados solos o en combinación fueron betalactámicos, fluoroquinolonas, vancomicina y carbapenémicos. Las áreas de internación con mayor frecuencia de presentación de la infección fueron las unidades de Clínica Médica, Traumatología, Geriatría y Unidad de Terapia Intensiva. La prevalencia de C. difficile toxigénico fue de 14%, y de esta frecuencia el 100% presentó toxinas TcdA y TcdB, con ausencia de toxinas binarias y deleción del gen tcdC. Se constató la presencia grupos clonales en la misma unidad de internación y misma institución de salud. El 100% de las cepas resultaron susceptibles a los antibióticos de elección para la infección. La prevalencia de la infección y presencia de perfiles clonales detectadas revelan la necesidad de un mejoramiento en el sistema de control de infecciones, así como del fortalecimiento y vigilancia de la resistencia antimicrobiana.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT 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.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Clostridioides difficile]]></kwd>
<kwd lng="es"><![CDATA[infección]]></kwd>
<kwd lng="es"><![CDATA[epidemiología]]></kwd>
<kwd lng="es"><![CDATA[antimicrobianos]]></kwd>
<kwd lng="es"><![CDATA[cepas clonales]]></kwd>
<kwd lng="en"><![CDATA[Clostridioides difficile]]></kwd>
<kwd lng="en"><![CDATA[infection]]></kwd>
<kwd lng="en"><![CDATA[epidemiology]]></kwd>
<kwd lng="en"><![CDATA[antimicrobials]]></kwd>
<kwd lng="en"><![CDATA[clonal strains]]></kwd>
</kwd-group>
</article-meta>
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