Abstract

VIEIRA, Ana Margarida et al. Clostridium Difficile - Associated Diarrhea in a Central Hospital. J Port Gastrenterol. [online]. 2010, vol.17, n.1, pp.10-17. ISSN 0872-8178.

INTRODUCTION: An increase in the incidence of Clostridium difficile-associated diarrhea (CDAD) and the appearance of a Clostridium difficile strain with increased virulence have been reported. AIMS: To characterize the epidemiologic and clinical aspects of the CDAD inpatients. MATERIAL AND METHODS: Retrospective analysis of patients with histological and/or laboratorial CDAD diagnosis admitted to our institution, between January 2000 and December 2007. RESULTS: A total of 93 inpatients with CDAD were evaluated with a mean age of 66 ± 16 years; 62% were male. An annual mean incidence of 3.71/10 000 inpatients was found, with an exponential increase in 2007. The infection was nosocomial in 55% of cases. History of antimicrobial intake was present in 82%. Toxin detection in stool, endoscopy and histology sensitivity were 86%, 84% and 69%, respectively. Sixty nine patients were treated, 61 of those with metronidazole. Recurrent and/or refractory disease was found in 10% and 17% patients, respectively. No mortality was recorded. CONCLUSIONS: We observed a recent increase in the incidence of CDAD. Prior antimicrobial treatment was the main risk factor. Clostridium difficile toxin in the stool detection was the most sensible method of diagnosis. Recurrent disease was more common with metronidazole. Metronidazole should not be recommended in severe disease.

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