Evaluation of inpatients Clostridium difficile prevalence and risk factors in Cameroon

Djuikoue, Cécile Ingrid; Tambo, Ernest; Tazemda, Gildas; Njajou, Omer T.; Makoudjou, Denise; Sokeng, Vanessa; Wandji, Morelle; Tomi, Charlène Nkouankou; Nanfack, Aubain; Dayomo, Audrey; Lacmago, Suzie; Tassadjo, Falubert; Sipowo, Raissa Talla; Kakam, Caroline; Djoko, Aicha Bibiane; Assob, Clement Nguedia; Andremont, Antoine; Barbut, Frédéric

doi:10.1186/s40249-020-00738-8

Cited by 7 publications

(5 citation statements)

References 21 publications

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“…Studies showed that toxin B participates in CDI severity, due to its involvement in both local and systemic host damage, and activation of the host inflammatory response [38][39][40]. Other studies found that toxin A is secreted more frequently than toxin B, consistent with our findings, but to a lesser extent [41,42].…”

Section: Discussionsupporting

confidence: 92%

Symptoms, Treatment, and Outcomes of COVID-19 Patients Coinfected with Clostridioides difficile: Single-Center Study from NE Romania during the COVID-19 Pandemic

et al. 2023

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The Coronavirus disease 2019 (COVID-19) pandemic has brought new challenges across medical disciplines, particularly in infectious disease medicine. In Romania, the incidence of SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2) infection increased dramatically since March 2020 until March 2022. Antibiotic administration for pulmonary superinfections in COVID-19 intensified and, consequently, increased rates of Clostridioides difficile infection (CDI) were hypothesized. We conducted a single-center, retrospective, observational study on patients from North-Eastern Romania to assess clinical characteristics and outcomes of COVID-19 and Clostridioides difficile (CD) coinfection, and to identify risk factors for CDI in COVID-19 patients. The study enrolled eighty-six CDI and COVID-19 coinfected patients admitted during March 2020–February 2021 (mean age 59.14 years, 53.49% men, 67.44% urban residents) and a group of eighty-six COVID-19 patients. On admission, symptoms were more severe in mono-infected patients, while coinfected patients associated a more intense acute inflammatory syndrome. The main risk factors for severe COVID-19 were smoking, diabetes mellitus, and antibiotic administration. Third generation cephalosporins (55%) and carbapenems (24%) were the main antibiotics used, and carbapenems were significantly associated with severe COVID-19 in patients coinfected with CD during hospitalization. Coinfection resulted in longer hospitalization and poorer outcomes. The extensive use of antibiotics in COVID-19, particularly carbapenems, contributed substantially to CD coinfection.

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Section: Discussionsupporting

confidence: 92%

Symptoms, Treatment, and Outcomes of COVID-19 Patients Coinfected with Clostridioides difficile: Single-Center Study from NE Romania during the COVID-19 Pandemic

et al. 2023

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“…Our findings showed a high prevalence of CDI mainly within the age group of 20 (28.1%). These findings of CDI among the above age group are concurrent with a study conducted by Djuikoue et al with a similar infection rate reported as having an almost similar prevalence rate (25.1%) [ 27 ].…”

Section: Discussionsupporting

confidence: 89%

“…In contrast to our study, a high resistance rate of ciprofloxacin was recorded in a study conducted by Tang et al which can be attributed to overprescribing of the broad-spectrum antibiotics [ 30 ]. In addition to fluoroquinolones, high-rate resistance was observed in amoxycillin + clavulanic acid (81%); therefore, it should be limited in hospital settings to reduce the risk of CDI [ 27 ]. Similarly, the resistance rates of cephalosporins such as cefixime and cefepime are recorded as 51% and 60%, respectively, against CDI [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Resistance and Associated Risk Factors for Clostridium difficile in Patients Attending Tertiary Care Settings

Mubaraki,

Hussain,

Hassan

et al. 2024

Journal of Tropical Medicine

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To determine the incidence of antimicrobial-resistant emerging pathogens, Clostridium difficile, and its associated risk factors in tertiary care setups of Pakistan. This cross-sectional prospective study was conducted from January 2019 to December 2020, to determine the prevalence and antimicrobial resistance patterns of C. difficile strains isolated from 450 stool specimens of patients suffering from diarrhea hospitalized in tertiary care hospitals in Peshawar, Pakistan. The stool samples of the patients were processed for culture and detection of toxin A and toxin B by enzyme-linked immunosorbent assay (ELISA) and tpi PCR. The drug sensitivity test was performed for antibiotics including ampicillin, cefixime, cefepime, amoxicillin, nalidixic acid, sulpha/TMP (SXT), chloramphenicol, metronidazole, vancomycin, ciprofloxacin, levofloxacin, and imipenem. Of 450 stool specimens, 108 (24%) were positive for C. difficile by stool culture, whereas 115 (25.5%) were only positive for C. difficile toxins based on ELISA and PCR (128 (28.6%). Of 108, 90.7% (n = 98) isolates were resistant to one antibiotic, and 90 (83.4%) were resistant to three or more antimicrobials. The highest resistance rates were found against penicillin (83.3%) followed by amoxicillin (70%), nalidixic acid (61%), and metronidazole (38%), and the lowest resistance was found against vancomycin (6.4%) and imipenem (3.7%). CDI was statistically significantly correlated with increased age, use of antibiotics, abdominal surgeries, use of proton pump inhibitors and H2a, and presence of comorbidities. The high frequency of C. difficile in Peshawar, Pakistan, indicates that CDI is an important nosocomial infection in different hospitals. The results will be helpful for clinicians to redesign control and therapeutic strategies in hospitals.

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“…Various factors have been very well studied and are known to be associated with an increased risk of developing Clostridioides difficile infection. These include prolonged use of broad-spectrum antibiotics, frequent hospitalizations, long-term residence at nursing care facilities, use of proton pump inhibitors, and steroids [ 18 , 19 , 20 ]. There are various other factors specific to oncology care patients that make them more vulnerable including (10 the use of chemotherapy, (2) newer immunotherapy and targeted drugs, (3) high and prolonged doses of steroids, (4) use of feeding tube, (5) multiple visits to hospitals and infusion centers and, (6) mucositis to list a few [ 16 , 21 , 22 , 23 , 24 , 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

To study the contributing factors and outcomes of Clostridioides difficile infection in patients with solid tumors

Sahu

Mishra

Jindal

et al. 2021

Heliyon

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Background Clostridioides difficile infection (CDI) is a considerable healthcare burden, and now identified as the leading cause of acquired diarrheal illness in patients receiving antibiotics. Patients with malignancies are more prone to acquire CDI, owing to their frequent exposure to risk factors. Objective This study aims to investigate the factors affecting the outcome of Clostridioides Difficile Infection in patients with solid tumors at our community healthcare center. Methods This is a retrospective study that included a total of 59 patients with solid tumors who were hospitalized for Clostridioides difficile infection. Results The median age of the study population was 79 years with 39 males and 20 females. The patients had a diagnosis of a malignancy involving the following sites: prostate (25), lung (19), colon (7), bladder (4), breast (3), and renal (1). There were 52 cases of first time and 7 cases of recurrent CDI admissions. 40 patients were detected to have CDI at presentation while 19 patients were diagnosed with CDI after admission. CDI was categorized as follows: non-severe (29), severe (28), and very severe (2). There were 33 patients on chemotherapy and 20 patients undergoing radiotherapy. Twenty-seven patients had a recent history of cancer care-related procedures or interventions. Twenty-nine patients were from either a rehabilitation center or a long-term nursing care facility. There were 39 recent hospitalizations with 29 patients receiving antibiotics. Almost half of the patients were on proton pump inhibitors (29) and 12 were on steroids (20.3%) at the time of developing CDI. Patients with a high-risk qSOFA score of 2 or more (p-value = 0.008) or a high white blood cell count of >15 × 10 9 /L (p-value = 0.016) at the time of admission were found to have higher in-hospital mortality. Critical care data suggested that 9 patients required intensive care, 7 patients required vasopressor support, and 6 needed mechanical ventilation. Patients were treated with either vancomycin alone (13), or metronidazole alone (25), or combination therapy with vancomycin + metronidazole (21). The median duration of hospital stay was 6 days with 11 fatalities (18.64%). Conclusions CDI causes significant morbidity in patients with malignancies. A high qSOFA score and leukocytosis are significantly associated with high morbidity and thus should be used to prioritize and intensify inpatient care of these patients.

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Evaluation of inpatients Clostridium difficile prevalence and risk factors in Cameroon

Cited by 7 publications

References 21 publications

Symptoms, Treatment, and Outcomes of COVID-19 Patients Coinfected with Clostridioides difficile: Single-Center Study from NE Romania during the COVID-19 Pandemic

Symptoms, Treatment, and Outcomes of COVID-19 Patients Coinfected with Clostridioides difficile: Single-Center Study from NE Romania during the COVID-19 Pandemic

Antimicrobial Resistance and Associated Risk Factors for Clostridium difficile in Patients Attending Tertiary Care Settings

To study the contributing factors and outcomes of Clostridioides difficile infection in patients with solid tumors

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