Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospital

Morfín Otero, Rayo y Garza González, Elvira y Aguirre Diaz, Sara Alejandra y Escobedo Sanchez, Rodrigo y Esparza Ahumada, Sergio y Pérez Gómez, Héctor R. y Petersen Morfin, Santiago y Gonzalez Diaz, Esteban E. y Martinez Melendez, Adrian y Rodríguez Noriega, Eduardo (2016) Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospital. The Brazilian Journal of Infectious Diseases, 20 (1). pp. 8-13. ISSN 14138670

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Resumen

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. difficile infection (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. difficile strain 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. difficile NAP1/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 of C. difficile infections is now part of our nosocomial prevention program.

Tipo de elemento: Article
Palabras claves no controlados: Clostridium difficile, Outbreak, 027 strain, Mexico
Usuario depositante: Lic. Jesús E. Alvarado
Creadores:
CreadorEmailORCID
Morfín Otero, RayoNO ESPECIFICADONO ESPECIFICADO
Garza González, ElviraNO ESPECIFICADONO ESPECIFICADO
Aguirre Diaz, Sara AlejandraNO ESPECIFICADONO ESPECIFICADO
Escobedo Sanchez, RodrigoNO ESPECIFICADONO ESPECIFICADO
Esparza Ahumada, SergioNO ESPECIFICADONO ESPECIFICADO
Pérez Gómez, Héctor R.NO ESPECIFICADONO ESPECIFICADO
Petersen Morfin, SantiagoNO ESPECIFICADONO ESPECIFICADO
Gonzalez Diaz, Esteban E.NO ESPECIFICADONO ESPECIFICADO
Martinez Melendez, AdrianNO ESPECIFICADONO ESPECIFICADO
Rodríguez Noriega, EduardoNO ESPECIFICADONO ESPECIFICADO
Fecha del depósito: 24 Mayo 2019 15:27
Última modificación: 08 Jun 2020 20:04
URI: http://eprints.uanl.mx/id/eprint/14877

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