Antibiotic-associated diarrhoea and Clostridium difficile> in the community (original) (raw)
Related papers
International Journal of Advanced Research
Context: C. difficile is a major cause of hospital acquired diarrhea. Aims: A prospective study was carried out to determine the prevalence of C. difficile in patients with antibiotic associated diarrhea (AAD) in a tertiary care hospital. Methods and Material: 162 stool samples were examined over a two year period for toxin A and toxin B via C. difficile Toxin A+B Stool Antigen Microwell ELISA kit (IVD Research Inc.). Clinical and demographic data was collected from all patients. Results: The prevalence of C. difficile associated diarrhea was found to be 4.32%. Highest number of C. difficile toxin positive cases was from stool samples of patients admitted in oncology/ hematology followed by internal medicine. Median time of occurrence of symptoms was 7 days after admittance to hospital. All the patients were on multiple antibiotics. Conclusion: This present prospective study draws attention to the role of C. difficile as a cause of AAD in our hospital. Active and aggressive surveill...
Bali Medical Journal, 2022
Clostridium difficile is an anaerobic gram-positive bacillus, capable of forming spores and toxins, transmitted to humans by the faecal-oral route C. difficile infection (CDI) is recognized as a typical cause healthcare-associated infections (HAIs) and contributes to a significant proportion of morbidity and mortality of hospitalized patients. C. difficile culture and toxin examinations are still minimal in many hospitals in various Asian countries. As a result, reports of C. difficile in Asia are still rare, while reports of cases of CDI in Indonesia are still rare. Several risk factors including advanced age, antibiotic exposure, and hospitalization are strongly associated with CDI. C. difficile has the ability to colonize the large intestine, then release exotoxin proteins (TcdA, TcdB) causing colitis in people with risk factors. A diagnosis of suspected C. difficile infection in a patient with diarrhea without a clear alternative explanation, with relevant risk factors (including long antibiotic consumption, hospitalization events, and elderly age), was then performed microbiological examination to carry out proper management and control of infection. This study aims to review C. difficile virulence factors as the cause of antibiotic-associated diarrhea.
American Journal of Infection Control, 2005
Background: Clostridium difficile is a toxin-producing bacterium that is responsible for toxicity to the colonic mucosa, causing inflammation, necrosis, and, in some extreme cases, intestinal dilation and perforation. C difficile-associated diarrhea (CDAD) occurs when patients have a reduction in their natural gastrointestinal flora that allows for the proliferation of and toxin production by C difficile. Methods: Using a multicenter, prospective observational case control study, we assessed and quantified risk factors associated with the development of diarrhea caused by Clostridium difficile, with particular attention to antibiotic use. All hospitalized patients with diarrhea requiring a C difficile toxin test as part of their routine clinical workup were considered for study inclusion. Patients with a negative specimen (controls) were considered for enrollment if matched (by age, sex, length of stay, and institution) to a case. Variables associated with CDAD were identified using univariate analysis. Significant factors were then entered into multivariate logistic regression analysis to identify independent factors. Results: There were no significant differences in antibiotic use between cases and controls. Patient severity, classified by Horn's Index, was significantly different between cases and controls (P 5 .0022). No other significant variables were identified. Conclusion: The severity of illness of the cases was classified as more severe than the controls, but no significant differences in antibiotic use were identified between the groups. The negative C difficile toxin studies on the well-matched control patients indicate a different etiology of diarrhea (such as antibiotic-associated diarrhea), which may have developed in the presence of similar antibiotic use as the cases.
The Indian journal of medical research, 2017
Clostridium difficile is the primary cause of hospital-acquired colitis in patients receiving antibiotics. The pathogenicity of the organism is mainly due to the production of toxins. This study was conducted to investigate the presence of toxigenic C. difficile in the faecal samples of hospitalized patients suspected to have C. difficile infection (CDI) and corroborating the findings with their clinical and demographic data. Diarrhoeic samples obtained from 1110 hospitalized patients were cultured for C. difficile and the isolates confirmed by phenotypic and molecular methods. Toxigenicity of the isolates was determined using enzyme-linked immunosorbent assay for toxins A and B. Details of patients included in the study were noted and analyzed. Of the 1110 patients (mean age 39±19.6 yr), 63.9 per cent were males and 36.1 per cent were females. The major antibiotics received by the patients were nitazoxanide (23.9%), penicillins/penicillin combinations (19.0%), quinolones including ...
Risk factors for the development ofClostridium difficile toxin-associated diarrhoea: a pilot study
Pharmacoepidemiol Drug Saf, 2001
This study was a pilot investigation of risk factors for the development of Clostridium dif®cile toxin-associated diarrhoea and in particular the differential in¯uence of antimicrobial agents. The study was a retrospective caseÐcontrol design conducted at Freeman Hospital, Newcastle upon Tyne. Cases were inpatients with stool positive C. dif®cile toxin diarrhoea and two controls were drawn for each case matched for age ( /À5 years) and type of admission (emergency or elective). Using conditional logistic regression analysis, cephalosporins and erythromycin were found to be statistically signi®cantly associated with Clostridium dif®cile toxin associated-diarrhoea. The results form the basis for designing a larger, prospective study.
Antibiotic Associated Diarrhea with Special Reference to Clostridium difficile
International Journal of Tropical Disease & Health, 2017
Introduction: Antibiotic associated diarrhea (AAD) is a common side effect of treatment with antibiotics. Depending on the antibiotic used, up to 25% of patients experience such unpleasant bowel conditions. The normal flora is replaced by pathogenic organisms like Candida species, Clostridium difficile etc which play an important role in the causation of AAD. Almost all the antibiotics have been associated with diarrhea. C. difficile is known to occur as an outbreak in health care settings in cases of AAD. However reports from India are infrequent. Aims: Our present study was undertaken to assess the role of different pathogen in causation of AAD and to evaluate the role of various antimicrobials in causation of AAD.
The Canadian journal of infectious diseases = Journal canadien des maladies infectieuses
To monitor prospectively patients with Clostridium difficile-associated diarrhea (CAD) in a six hundred bed tertiary care hospital to determine which factors influenced the recurrence of the diarrhea. A prospective, nonrandomized study. After an initial diagnosis of CAD, patients were interviewed, and each week stool samples and environmental samples were monitored for the presence of toxigenic C difficile for as long as the patients remained in hospital. The relationship of concurrent antibiotics, prolonged fecal excretion of organism or toxin, and environmental contamination was assessed. Over a two-and-a-half year period, 75 consecutive patients with CAD were selected and those who gave their written informed consent were enrolled. A control group to evaluate environmental contamination consisted of 75 patients with diarrhea not associated with C difficile. Of the 75 CAD patients, 11 (14.7%) had a recurrence of their diarrhea. Diarrhea recurrence was associated with an increased ...
Journal of Hospital Infection, 2003
We describe the risk factors and microbiological findings of an outbreak of Clostridium difficile (CD)-related diarrhoea in the Medical Oncology Department of the Curie Institute. Screening for CD in stools was performed on 59 patients with diarrhoea and 146 patients without diarrhoea. Toxin secretion, serotyping (enzyme-linked immunosorbant assay) and genotyping (AP-polymerase chain reaction) were performed on 39 CD strains from 32 patients. The risk factors for toxigenic CD-positive diarrhoea were also investigated. Twenty-seven (46%) patients with diarrhoea and 12 (8%) patients without diarrhoea were CDpositive (P`0.001). Patients with diarrhoea were older (P 0.03). Chemotherapy was a risk factor for toxigenic CD-related diarrhoea (P 0.02) and antibiotic treatment was a risk factor only in those patients who were also receiving chemotherapy. Serotyping and genotyping showed that several strains were involved in this outbreak, with only two instances of patient-to-patient transmission, involving four and two patients.