Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospital
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Brazilian Journal of Infectious Diseases |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702016000100008 |
Resumo: | Abstract Background Clostridium difficile infections caused by the NAP1/B1/027 strain are more severe, difficult to treat, and frequently associated with relapses. Methods A case–control study was designed to examine a C. difficileinfection (CDI) outbreak over a 12-month period in a Mexican hospital. The diagnosis of toxigenic CDI was confirmed by real-time polymerase chain reaction, PCR (Cepheid Xpert C. difficile/Epi). Results During the study period, 288 adult patients were evaluated and 79 (27.4%) patients had confirmed CDI (PCR positive). C. difficilestrain NAP1/B1/027 was identified in 31 (39%) of the patients with confirmed CDI (240 controls were included). Significant risk factors for CDI included any underlying disease (p < 0.001), prior hospitalization (p < 0.001), and antibiotic (p < 0.050) or steroid (p < 0.001) use. Laboratory abnormalities included leukocytosis (p < 0.001) and low serum albumin levels (p < 0.002). Attributable mortality was 5%. Relapses occurred in 10% of patients. Risk factors for C. difficileNAP1/B1/027 strain infections included prior use of quinolones (p < 0.03). Risk factors for CDI caused by non-027 strains included chronic cardiac disease (p < 0.05), chronic renal disease (p < 0.009), and elevated serum creatinine levels (p < 0.003). Deaths and relapses were most frequent in the 027 group (10% and 19%, respectively). Conclusions C. difficile NAP1/BI/027 strain and non-027 strains are established pathogens in our hospital. Accordingly, surveillance ofC. difficile infections is now part of our nosocomial prevention program. |
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Brazilian Journal of Infectious Diseases |
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Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospitalClostridium difficileOutbreak027 strainMexicoAbstract Background Clostridium difficile infections caused by the NAP1/B1/027 strain are more severe, difficult to treat, and frequently associated with relapses. Methods A case–control study was designed to examine a C. difficileinfection (CDI) outbreak over a 12-month period in a Mexican hospital. The diagnosis of toxigenic CDI was confirmed by real-time polymerase chain reaction, PCR (Cepheid Xpert C. difficile/Epi). Results During the study period, 288 adult patients were evaluated and 79 (27.4%) patients had confirmed CDI (PCR positive). C. difficilestrain NAP1/B1/027 was identified in 31 (39%) of the patients with confirmed CDI (240 controls were included). Significant risk factors for CDI included any underlying disease (p < 0.001), prior hospitalization (p < 0.001), and antibiotic (p < 0.050) or steroid (p < 0.001) use. Laboratory abnormalities included leukocytosis (p < 0.001) and low serum albumin levels (p < 0.002). Attributable mortality was 5%. Relapses occurred in 10% of patients. Risk factors for C. difficileNAP1/B1/027 strain infections included prior use of quinolones (p < 0.03). Risk factors for CDI caused by non-027 strains included chronic cardiac disease (p < 0.05), chronic renal disease (p < 0.009), and elevated serum creatinine levels (p < 0.003). Deaths and relapses were most frequent in the 027 group (10% and 19%, respectively). Conclusions C. difficile NAP1/BI/027 strain and non-027 strains are established pathogens in our hospital. Accordingly, surveillance ofC. difficile infections is now part of our nosocomial prevention program.Brazilian Society of Infectious Diseases2016-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702016000100008Brazilian Journal of Infectious Diseases v.20 n.1 2016reponame:Brazilian Journal of Infectious Diseasesinstname:Brazilian Society of Infectious Diseases (BSID)instacron:BSID10.1016/j.bjid.2015.09.008info:eu-repo/semantics/openAccessMorfin-Otero,RayoGarza-Gonzalez,ElviraAguirre-Diaz,Sara A.Escobedo-Sanchez,RodrigoEsparza-Ahumada,SergioPerez-Gomez,Hector R.Petersen-Morfin,SantiagoGonzalez-Diaz,EstebanMartinez-Melendez,AdrianRodriguez-Noriega,Eduardoeng2016-03-14T00:00:00Zoai:scielo:S1413-86702016000100008Revistahttps://www.bjid.org.br/https://old.scielo.br/oai/scielo-oai.phpbjid@bjid.org.br||lgoldani@ufrgs.br1678-43911413-8670opendoar:2016-03-14T00:00Brazilian Journal of Infectious Diseases - Brazilian Society of Infectious Diseases (BSID)false |
dc.title.none.fl_str_mv |
Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospital |
title |
Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospital |
spellingShingle |
Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospital Morfin-Otero,Rayo Clostridium difficile Outbreak 027 strain Mexico |
title_short |
Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospital |
title_full |
Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospital |
title_fullStr |
Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospital |
title_full_unstemmed |
Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospital |
title_sort |
Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospital |
author |
Morfin-Otero,Rayo |
author_facet |
Morfin-Otero,Rayo Garza-Gonzalez,Elvira Aguirre-Diaz,Sara A. Escobedo-Sanchez,Rodrigo Esparza-Ahumada,Sergio Perez-Gomez,Hector R. Petersen-Morfin,Santiago Gonzalez-Diaz,Esteban Martinez-Melendez,Adrian Rodriguez-Noriega,Eduardo |
author_role |
author |
author2 |
Garza-Gonzalez,Elvira Aguirre-Diaz,Sara A. Escobedo-Sanchez,Rodrigo Esparza-Ahumada,Sergio Perez-Gomez,Hector R. Petersen-Morfin,Santiago Gonzalez-Diaz,Esteban Martinez-Melendez,Adrian Rodriguez-Noriega,Eduardo |
author2_role |
author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Morfin-Otero,Rayo Garza-Gonzalez,Elvira Aguirre-Diaz,Sara A. Escobedo-Sanchez,Rodrigo Esparza-Ahumada,Sergio Perez-Gomez,Hector R. Petersen-Morfin,Santiago Gonzalez-Diaz,Esteban Martinez-Melendez,Adrian Rodriguez-Noriega,Eduardo |
dc.subject.por.fl_str_mv |
Clostridium difficile Outbreak 027 strain Mexico |
topic |
Clostridium difficile Outbreak 027 strain Mexico |
description |
Abstract Background Clostridium difficile infections caused by the NAP1/B1/027 strain are more severe, difficult to treat, and frequently associated with relapses. Methods A case–control study was designed to examine a C. difficileinfection (CDI) outbreak over a 12-month period in a Mexican hospital. The diagnosis of toxigenic CDI was confirmed by real-time polymerase chain reaction, PCR (Cepheid Xpert C. difficile/Epi). Results During the study period, 288 adult patients were evaluated and 79 (27.4%) patients had confirmed CDI (PCR positive). C. difficilestrain NAP1/B1/027 was identified in 31 (39%) of the patients with confirmed CDI (240 controls were included). Significant risk factors for CDI included any underlying disease (p < 0.001), prior hospitalization (p < 0.001), and antibiotic (p < 0.050) or steroid (p < 0.001) use. Laboratory abnormalities included leukocytosis (p < 0.001) and low serum albumin levels (p < 0.002). Attributable mortality was 5%. Relapses occurred in 10% of patients. Risk factors for C. difficileNAP1/B1/027 strain infections included prior use of quinolones (p < 0.03). Risk factors for CDI caused by non-027 strains included chronic cardiac disease (p < 0.05), chronic renal disease (p < 0.009), and elevated serum creatinine levels (p < 0.003). Deaths and relapses were most frequent in the 027 group (10% and 19%, respectively). Conclusions C. difficile NAP1/BI/027 strain and non-027 strains are established pathogens in our hospital. Accordingly, surveillance ofC. difficile infections is now part of our nosocomial prevention program. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-02-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702016000100008 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702016000100008 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1016/j.bjid.2015.09.008 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Brazilian Society of Infectious Diseases |
publisher.none.fl_str_mv |
Brazilian Society of Infectious Diseases |
dc.source.none.fl_str_mv |
Brazilian Journal of Infectious Diseases v.20 n.1 2016 reponame:Brazilian Journal of Infectious Diseases instname:Brazilian Society of Infectious Diseases (BSID) instacron:BSID |
instname_str |
Brazilian Society of Infectious Diseases (BSID) |
instacron_str |
BSID |
institution |
BSID |
reponame_str |
Brazilian Journal of Infectious Diseases |
collection |
Brazilian Journal of Infectious Diseases |
repository.name.fl_str_mv |
Brazilian Journal of Infectious Diseases - Brazilian Society of Infectious Diseases (BSID) |
repository.mail.fl_str_mv |
bjid@bjid.org.br||lgoldani@ufrgs.br |
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1754209243672608768 |