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Biomédica
Print version ISSN 0120-4157
Abstract
CARVAJAL, Carlos; PACHECO, Carlos and JAIMES, Fabián. Clinical and demographic profile and risk factors for Clostridium difficile infection. Biomédica [online]. 2017, vol.37, n.1, pp.53-61. ISSN 0120-4157. https://doi.org/10.7705/biomedica.v37i1.2915.
Introduction:
Clostridium difficile infection is the leading cause of nosocomial infectious diarrhea. The increasing incidence added to a lower rate of response to the initial treatment and higher rates of relapse has generated a higher burden of the disease.
Objective:
To determine the clinical characteristics of hospitalized patients with C. difficile infection.
Materials and methods:
We made a nested case-cohort study. We reviewed medical records of the patients with nosocomial diarrhea for whom an assay for toxin A-B of C. difficile had been requested from February, 2010, to February, 2012. We defined case as a patient with diarrhea and a positive assay for the toxin, and control as those patients with a negative assay for the toxin. We collected data on demographic and clinical characteristics, risk factors, hospital length of stay, treatment, and complications.
Results:
We collected data from 123 patients during the follow-up period, 30 of whom were positive for the toxin. Mean age in the study population was 49 years and 60% were men. The main symptoms were abdominal pain (35%) and fever (34%). The principal complications were electrolytic alteration and severe sepsis with secondary acute kidney injury. Mortality was 13% and independent factors associated to the appearance of the infection were the use of proton pump inhibitors and previous gastrointestinal tract surgery.
Conclusions:
The use of proton pump inhibitors and previous gastrointestinal tract surgery were factors associated to C. difficile infection.
Keywords : Clostridium difficile; epidemiology; dysentery; anti-bacterial agents; risk factors; cross infection.