Low prevalence of Clostridioides difficile infection in Reference Hospitals in Oncology

Detalhes bibliográficos
Autor(a) principal: Tenório, Catarina
Data de Publicação: 2021
Outros Autores: Araújo, Paulo Sérgio Ramos de, Lins, Ana Kelly, Sobrinho, Carlos Roberto Weber, Magalhães, Vera
Tipo de documento: Artigo
Idioma: por
Título da fonte: Research, Society and Development
Texto Completo: https://rsdjournal.org/index.php/rsd/article/view/15612
Resumo: The severity and incidence of Clostridioides difficile infection (CDI) have increased over the last decade. Cancer predisposes patients to CDI due to increased exposure to risk factors. The present study aimed to determine the prevalence, clinical response, outcomes, risk factors as supported in the literature in cancer patients with CDI. This was a prospective cross-sectional study conducted at two reference centres in oncology in Recife-PE, Brazil and involved individuals aged ≥18 years who presented with diarrhoea 48 hours after hospital admission, from November 2017 to August 2019. CDI was diagnosed using real-time polymerase chain reaction (qRT-PCR). A total of 156 patients were included in the study, and CDI was detected in 7.05% (11/156) of the patients. All isolates were screened, and the DNA was isolated and amplified by qRT-PCR for the detection of genes coding for toxins A and B (tcdA and tcdB), binary toxin (cdtA), and triose phosphate isomerase (tpi). Breast cancer and acute lymphoid leukemia were the most frequent cancers (27.3% [3/11] and 18.2% [2/11], respectively); 90.9% (10/11) of the cases used antibiotics, and the mortality rate was 63.6% (7/11 patients). Despite the use of the qRT-PCR technique, which is the most sensitive and specific method for diagnosing CDI, it was found that the prevalence of the disease was low (7.05%; 11/156). There were no cases of severe CDI, and most cases found were mild, which suggests the circulation of strains with low virulence that determine lower morbidity and mortality.
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spelling Low prevalence of Clostridioides difficile infection in Reference Hospitals in OncologyBaja prevalencia de infecciones por Clostridioides difficile en Hospitales de Referencia OncológicaBaixa prevalência de infecções por Clostridioides difficile em Hospitais de Referência em OncologiaInfección por Clostridioides difficileCáncerAntibióticosQuimioterápicosqRT-PCR.Clostridioides difficile infectionCancerAntibioticsChemotherapyqRT-PCR.Clostridioides difficile infecçãoCâncerAntibióticosQuimioterápicosqRT-PCR.The severity and incidence of Clostridioides difficile infection (CDI) have increased over the last decade. Cancer predisposes patients to CDI due to increased exposure to risk factors. The present study aimed to determine the prevalence, clinical response, outcomes, risk factors as supported in the literature in cancer patients with CDI. This was a prospective cross-sectional study conducted at two reference centres in oncology in Recife-PE, Brazil and involved individuals aged ≥18 years who presented with diarrhoea 48 hours after hospital admission, from November 2017 to August 2019. CDI was diagnosed using real-time polymerase chain reaction (qRT-PCR). A total of 156 patients were included in the study, and CDI was detected in 7.05% (11/156) of the patients. All isolates were screened, and the DNA was isolated and amplified by qRT-PCR for the detection of genes coding for toxins A and B (tcdA and tcdB), binary toxin (cdtA), and triose phosphate isomerase (tpi). Breast cancer and acute lymphoid leukemia were the most frequent cancers (27.3% [3/11] and 18.2% [2/11], respectively); 90.9% (10/11) of the cases used antibiotics, and the mortality rate was 63.6% (7/11 patients). Despite the use of the qRT-PCR technique, which is the most sensitive and specific method for diagnosing CDI, it was found that the prevalence of the disease was low (7.05%; 11/156). There were no cases of severe CDI, and most cases found were mild, which suggests the circulation of strains with low virulence that determine lower morbidity and mortality.Las infecciones por Clostridioides difficile (CDI) han aumentado en gravedad e incidencia durante la última década. El cáncer predispone a los pacientes a la CDI, debido a una mayor exposición a factores de riesgo. El presente estudio tuvo como objetivo determinar la prevalencia, respuesta clínica, resultado, describir los factores de riesgo establecidos en la literatura en pacientes oncológicos con CDI. El estudio se llevó a cabo en dos servicios de referencia oncológica de Recife/PE e involucró a personas ≥18 años, que presentaron diarrea a las 48 horas del ingreso hospitalario, de noviembre/2017 a agosto/2019. Para el diagnóstico de CDI se utilizó el examen de Reacción en Cadena de Polimerasa en Tiempo Real (qRT-PCR). Se incluyeron un total de 156 pacientes, la CDI se identificó en el 7,05% (11/156) de los pacientes estudiados, todos los aislamientos se rastrearon y amplificaron mediante qRT-PCR para detectar la presencia de los genes que codifican las toxinas A y B (tcdA y tcdB), toxina binaria (cdtA) y triosa fosfato isomerasa (tpi). El cáncer de mama el 27,3% (3/11) y la leucemia linfoide aguda el 18,2% (2/11) fueron los cánceres más frecuentes; el 90,9% (10/11) utilizaba antibióticos y el 63,6% (7/11) de los casos fallecieron. A pesar de utilizar la técnica qRT-PCR, que es la más sensible y específica, la prevalencia de CDI fue baja 7,05% (11/156), no se registraron casos de CDI grave, siendo la mayoría de casos leves, lo que sugiere una circulación de cepas de baja virulencia que determinan una menor morbilidad y mortalidad.As infecções por Clostridioides difficile (CDI) aumentaram em gravidade e incidência durante a última década. O câncer predispõe os pacientes à CDI, devido à maior exposição aos fatores de risco. O presente estudo teve como objetivo determinar a prevalência, resposta clínica, desfecho, descrever os fatores de risco estabelecidos na literatura em pacientes oncológicos com CDI. O estudo foi realizado em dois serviços de referência em oncologia de Recife/PE e envolveu pessoas com idade ≥18 anos, que apresentaram o quadro de diarreia após 48horas da admissão hospitalar, no período de novembro/2017 a agosto/2019.  Para o diagnóstico de CDI  foi utilizado o exame Reação em Cadeia da Polimerase em Tempo Real (qRT-PCR). Um total de 156 pacientes foram incluídos, a CDI foi identificada em 7,05% (11/156) dos pacientes estudados, todos isolados foram rastreados e amplificados por qRT-PCR quanto à presença dos genes que codificam as toxinas A e B (tcdA e tcdB), toxina binária (cdtA) e triose fosfato isomerase (tpi). O câncer de mama 27,3% (3/11) e a leucemia linfóide aguda 18,2% (2/11) foram os cânceres mais frequentes; 90,9% (10/11) fizeram uso de antibióticos e 63,6% (7/11) dos casos evoluíram para óbito. Apesar de utilizar a técnica qRT-PCR, que é a mais sensível e específica, a prevalência de CDI foi baixa 7,05% (11/156), não houve registros de casos de CDI graves, sendo a maioria dos casos leves, o que sugere uma circulação de cepas com baixa virulência que determinam menor morbidade e mortalidade.Research, Society and Development2021-05-26info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://rsdjournal.org/index.php/rsd/article/view/1561210.33448/rsd-v10i6.15612Research, Society and Development; Vol. 10 No. 6; e16710615612Research, Society and Development; Vol. 10 Núm. 6; e16710615612Research, Society and Development; v. 10 n. 6; e167106156122525-3409reponame:Research, Society and Developmentinstname:Universidade Federal de Itajubá (UNIFEI)instacron:UNIFEIporhttps://rsdjournal.org/index.php/rsd/article/view/15612/13985Copyright (c) 2021 Catarina Tenório; Paulo Sérgio Ramos de Araújo; Ana Kelly Lins; Carlos Roberto Weber Sobrinho; Vera Magalhãeshttps://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessTenório, CatarinaAraújo, Paulo Sérgio Ramos de Lins, Ana Kelly Sobrinho, Carlos Roberto Weber Magalhães, Vera 2021-06-10T22:51:46Zoai:ojs.pkp.sfu.ca:article/15612Revistahttps://rsdjournal.org/index.php/rsd/indexPUBhttps://rsdjournal.org/index.php/rsd/oairsd.articles@gmail.com2525-34092525-3409opendoar:2024-01-17T09:36:23.811724Research, Society and Development - Universidade Federal de Itajubá (UNIFEI)false
dc.title.none.fl_str_mv Low prevalence of Clostridioides difficile infection in Reference Hospitals in Oncology
Baja prevalencia de infecciones por Clostridioides difficile en Hospitales de Referencia Oncológica
Baixa prevalência de infecções por Clostridioides difficile em Hospitais de Referência em Oncologia
title Low prevalence of Clostridioides difficile infection in Reference Hospitals in Oncology
spellingShingle Low prevalence of Clostridioides difficile infection in Reference Hospitals in Oncology
Tenório, Catarina
Infección por Clostridioides difficile
Cáncer
Antibióticos
Quimioterápicos
qRT-PCR.
Clostridioides difficile infection
Cancer
Antibiotics
Chemotherapy
qRT-PCR.
Clostridioides difficile infecção
Câncer
Antibióticos
Quimioterápicos
qRT-PCR.
title_short Low prevalence of Clostridioides difficile infection in Reference Hospitals in Oncology
title_full Low prevalence of Clostridioides difficile infection in Reference Hospitals in Oncology
title_fullStr Low prevalence of Clostridioides difficile infection in Reference Hospitals in Oncology
title_full_unstemmed Low prevalence of Clostridioides difficile infection in Reference Hospitals in Oncology
title_sort Low prevalence of Clostridioides difficile infection in Reference Hospitals in Oncology
author Tenório, Catarina
author_facet Tenório, Catarina
Araújo, Paulo Sérgio Ramos de
Lins, Ana Kelly
Sobrinho, Carlos Roberto Weber
Magalhães, Vera
author_role author
author2 Araújo, Paulo Sérgio Ramos de
Lins, Ana Kelly
Sobrinho, Carlos Roberto Weber
Magalhães, Vera
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Tenório, Catarina
Araújo, Paulo Sérgio Ramos de
Lins, Ana Kelly
Sobrinho, Carlos Roberto Weber
Magalhães, Vera
dc.subject.por.fl_str_mv Infección por Clostridioides difficile
Cáncer
Antibióticos
Quimioterápicos
qRT-PCR.
Clostridioides difficile infection
Cancer
Antibiotics
Chemotherapy
qRT-PCR.
Clostridioides difficile infecção
Câncer
Antibióticos
Quimioterápicos
qRT-PCR.
topic Infección por Clostridioides difficile
Cáncer
Antibióticos
Quimioterápicos
qRT-PCR.
Clostridioides difficile infection
Cancer
Antibiotics
Chemotherapy
qRT-PCR.
Clostridioides difficile infecção
Câncer
Antibióticos
Quimioterápicos
qRT-PCR.
description The severity and incidence of Clostridioides difficile infection (CDI) have increased over the last decade. Cancer predisposes patients to CDI due to increased exposure to risk factors. The present study aimed to determine the prevalence, clinical response, outcomes, risk factors as supported in the literature in cancer patients with CDI. This was a prospective cross-sectional study conducted at two reference centres in oncology in Recife-PE, Brazil and involved individuals aged ≥18 years who presented with diarrhoea 48 hours after hospital admission, from November 2017 to August 2019. CDI was diagnosed using real-time polymerase chain reaction (qRT-PCR). A total of 156 patients were included in the study, and CDI was detected in 7.05% (11/156) of the patients. All isolates were screened, and the DNA was isolated and amplified by qRT-PCR for the detection of genes coding for toxins A and B (tcdA and tcdB), binary toxin (cdtA), and triose phosphate isomerase (tpi). Breast cancer and acute lymphoid leukemia were the most frequent cancers (27.3% [3/11] and 18.2% [2/11], respectively); 90.9% (10/11) of the cases used antibiotics, and the mortality rate was 63.6% (7/11 patients). Despite the use of the qRT-PCR technique, which is the most sensitive and specific method for diagnosing CDI, it was found that the prevalence of the disease was low (7.05%; 11/156). There were no cases of severe CDI, and most cases found were mild, which suggests the circulation of strains with low virulence that determine lower morbidity and mortality.
publishDate 2021
dc.date.none.fl_str_mv 2021-05-26
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://rsdjournal.org/index.php/rsd/article/view/15612
10.33448/rsd-v10i6.15612
url https://rsdjournal.org/index.php/rsd/article/view/15612
identifier_str_mv 10.33448/rsd-v10i6.15612
dc.language.iso.fl_str_mv por
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dc.relation.none.fl_str_mv https://rsdjournal.org/index.php/rsd/article/view/15612/13985
dc.rights.driver.fl_str_mv https://creativecommons.org/licenses/by/4.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/4.0
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Research, Society and Development
publisher.none.fl_str_mv Research, Society and Development
dc.source.none.fl_str_mv Research, Society and Development; Vol. 10 No. 6; e16710615612
Research, Society and Development; Vol. 10 Núm. 6; e16710615612
Research, Society and Development; v. 10 n. 6; e16710615612
2525-3409
reponame:Research, Society and Development
instname:Universidade Federal de Itajubá (UNIFEI)
instacron:UNIFEI
instname_str Universidade Federal de Itajubá (UNIFEI)
instacron_str UNIFEI
institution UNIFEI
reponame_str Research, Society and Development
collection Research, Society and Development
repository.name.fl_str_mv Research, Society and Development - Universidade Federal de Itajubá (UNIFEI)
repository.mail.fl_str_mv rsd.articles@gmail.com
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