Prevalência do clostridium difficile e associação com a antibióticoterapia em um grupo de indivíduos do sul do Brasil

• Autor(a) principal: Rodrigues, Luiz Fernando Vieira
• Data de Publicação: 2005
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional PUCRS
• Texto Completo: http://hdl.handle.net/10923/3731
• topic: GERIATRIA; GERONTOLOGIA; IDOSOS - DOENÇAS; DIARREIA; HOSPITALIZAÇÃO; INFECÇÃO HOSPITALAR

Clostridium difficile (Cd), a Gram-positive, spore-forming anaerobic bacillus, is widely distributed in the hospital environment, and inhabits both human and animal gastrointestinal tract microbiota. It has been associated with outbreaks of pseudomembranous colitis (PMC) and other intestinal disorders, such as diarrhea, related with previous use of the antibiotics. The goal of this study was to retrospectively evaluate Cd toxin A prevalence in individuals tested in Weinmann Laboratory, from June 2003 to December 2004. For detection of Cd toxin A, the automated system VIDAS C. difficile Toxin A II (CDA2, Biomérieux S. A. ) was used. It is an enzyme-linked fluorescent immunossay (ELFA) for the qualitative detection of Cd toxin A in stool specimens. Two hundred and eighty eight results were analyzed, 91 of hospital origin (31. 6%) and 197 (68. 4%) out patients. Cd prevalence in samples from hospitalized patients was 11. 0% and 11. 7% in outpatients. Mean age of elderly patients (n=139) was 76. 3 years, with a median of 76, and the Cd prevalence was 9. 4%. Among hospitalized patients under antibiotics therapy, Cd prevalence was 11. 5%. Patient’s treatment with a single antibiotic category showed a significant relationship with Cd positivity (p=0. 001), when compared with use of more than one category. Association between fever, abdominal pain, hipoalbuminemia, dehydration, electrolytic imbalance, fecal leucocytes presence and protein C results were analyzed. A statistically significant association with Cd prevalence was found only for hipoalbuminemia (p=0,048).