Prevalence of Clostridium Difficile-Associated Diarrhoea in Hospitalised Patients (Results of a Russian Prospective Multicentre Study)

Abstract

IntroductionThe objective of the study was to evaluate the prevalence of Clostridium difficile-associated diarrhoea (CDAD) among hospitalised patients with antibiotic-associated diarrhoea (AAD) in general and by specific types of medical care and hospital units.MethodsA prospective, cross-sectional, non-interventional, multicentre study. The main inclusion criteria were: patient age ≥ 18 years, hospital stay of at least 48 h, current antibiotic therapy or antibiotic therapy within the previous 30 days, loose stools (Bristol stool types 5–7 and stool frequency ≥ 3 within ≤ 24 consecutive hours or exceeding normal for the patient) and signed informed consent form. The stool sample was taken to the local (study site) microbiology laboratory for detection of glutamate dehydrogenase (GDH) and toxins A/B using enzyme immunoassay (EIA) stool test.ResultsFrom April 2016 to April 2017, a total of 1245 patients from 12 large hospitals were enrolled in the study. Data on 81 patients were excluded from the analysis for different reasons. Data on 1164 patients (45.2% males and 54.8% females) with a mean age of 54.9 years (range 18–95 years) were analysed. Length of hospitalisation was 2–188 days (median, 8 days). The EIA stool test showed CDAD-positive results in 21.7% (253/1164) patients. The patients were from surgery units (546/1164), internal medicine units (510/1164) and intensive care units (108/1164). The prevalence of CDAD among patients from surgery, internal medicine and intensive care units was 26.2, 17.8 and 17.6%, respectively. Oncology, gastroenterology, septic surgery, oncohaematology and general medical hospital units accounted for more than 75% of all patients included; the prevalence of CDAD by those hospital units was 11.3, 15.0, 39.2, 17.6, and 27.2%, respectively. The proportion of GDH-positive and toxin A/B-negative patients by the rapid stool test result was 16.8% (196/1164). The prevalence of CDAD varied widely between the hospitals (from 0 to 44.3%).ConclusionsThe prevalence of CDAD among hospitalised patients with AAD in this study was 21.7% (95% confidence interval: 14.8 and 28.7%). The percentage of CDAD varied widely between hospitals and by specific types of medical care and hospital units.

Evaluation of inpatients Clostridium difficile prevalence and risk factors in Cameroon

“…Multivariate analysis showed that imidazole family was responsible of diarrhea in inpatients and statistically significant association with C. difficile of 60% in inpatients having used this antibiotics ( P = 0.036, a OR = 29.06). This result is contrary to Natalia et al in Russia in 2018 [ 16 ], where the β- lactamases group and quinolones were linked to patients with C. difficile . 11.86% of hospitalized patients had diarrhea but not statistically significant univariate analysis; this result is lower that Sachu et al [ 17 ] of 21.7% inpatients admission with diarrhea.…”

Clostridium Difficile Infection: Current Approaches to Diagnosis and Treatment

“…Если до середины прошлого века этот микроорганизм считался представителем нормальной микрофлоры кишечника, типичным для детей первых лет жизни и гораздо реже встречающимся у взрослых, то начиная примерно с 1970-х годов с ним стали увязывать развитие диареи и появление псевдомембран в кишечнике у пациентов, получавших антибиотики. С тех пор его ведущая роль в развитии антибиотик-ассоциированных диарей в России и за рубежом была неоднократно подтверждена, и в наши дни C. difficile считается одним из наиболее значимых возбудителей нозокомиальных инфекций, встречающимся в отделениях различного профиля [2,4,6,15,16,32,37,46,49].…”

<i>Clostridioides difficile</i> infection: diagnosis, treatment, and prevention Clinical guidelines of the Russian Scientific Medical Society of Internal Medicine, the Gastroenterological Scientific Society of Russia, and the North- West Society of Gastroenterologists and Hepatologists

“…В многопрофильном стационаре Санкт-Петербурга CDI была диагностирована в 51,5% случаев антибиотикоассоциированной диареи [13]. Распространенность бессимптомной колонизации C. diffi cile в стационарах скорой медицинской помощи по данным разных авторов составляла 3-26% [14,15].…”