INTRODUCTION: Clostridium difficile-associated disease (CDAD) has been clearly associated with the use of broad-spectrum antibiotics worldwide. However, information about CDAD is scarce in Mexico and Latin America. MATERIAL AND METHODS: We studied clinical characteristics, associated factors and outcomes of all cases of CDAD diagnosed by toxin A fecal detection in a tertiary care hospital in Mexico City from 2003 to 2007. Cases were paired with controls by date of hospital discharge. RESULTS. A total of 3170 tests were performed; we evaluated 113 cases and 226 controls, with an incidence of 5.04 cases x 1000 hospital discharges during the study period. There was no difference in gender or primary diagnosis. After multivariate analysis, we found as significant risks the following: use of H2 blockers (OR 21.73, 95% CI 7.14-66.67, p < 0.001), age < 65 y (OR 10.21, IC95% 2.74-38.00, p < 0.001), prior hospitalization within 12 weeks of diagnosis (OR 4.39, IC95% 1.81-40.64, p < 0.001), prior use of cephalosporins (OR 3.41, CI 95% 1.56-7.46, p = 0.002), and fluoroquinolones (OR 3.11, IC95% 1.12-8.62, p = 0.029), stay at the intensive care unit (ICU) (OR 2.76, IC95% 1.38-5.49, p = 0.004); and, extended hospital stay (OR 1.10, IC95% 1.05-1.16, p < 0.001) or antimicrobial use before diagnosis (OR 1.05, IC95% 1.01-1.09, p = 0.010). We described an outbreak of 12 cases occurred in August of 2005 (29.5 cases per 1,000 discharges). We also observed a higher seasonal incidence of disease during the summer in the study period. CONCLUSIONS: The use of H2 blockers, age < 65 years, prior hospitalization or earlier use of cephalosporins or fluoroquinolones, as well as stay at the ICU were independent risk factor for CDAD.
INTRODUCTION:Clostridium difficile-associated disease (CDAD) has been clearly associated with the use of broad-spectrum antibiotics worldwide. However, information about CDAD is scarce in Mexico and Latin America. MATERIAL AND METHODS: We studied clinical characteristics, associated factors and outcomes of all cases of CDAD diagnosed by toxin A fecal detection in a tertiary care hospital in Mexico City from 2003 to 2007. Cases were paired with controls by date of hospital discharge. RESULTS. A total of 3170 tests were performed; we evaluated 113 cases and 226 controls, with an incidence of 5.04 cases x 1000 hospital discharges during the study period. There was no difference in gender or primary diagnosis. After multivariate analysis, we found as significant risks the following: use of H2 blockers (OR 21.73, 95% CI 7.14-66.67, p < 0.001), age < 65 y (OR 10.21, IC95% 2.74-38.00, p < 0.001), prior hospitalization within 12 weeks of diagnosis (OR 4.39, IC95% 1.81-40.64, p < 0.001), prior use of cephalosporins (OR 3.41, CI 95% 1.56-7.46, p = 0.002), and fluoroquinolones (OR 3.11, IC95% 1.12-8.62, p = 0.029), stay at the intensive care unit (ICU) (OR 2.76, IC95% 1.38-5.49, p = 0.004); and, extended hospital stay (OR 1.10, IC95% 1.05-1.16, p < 0.001) or antimicrobial use before diagnosis (OR 1.05, IC95% 1.01-1.09, p = 0.010). We described an outbreak of 12 cases occurred in August of 2005 (29.5 cases per 1,000 discharges). We also observed a higher seasonal incidence of disease during the summer in the study period. CONCLUSIONS: The use of H2 blockers, age < 65 years, prior hospitalization or earlier use of cephalosporins or fluoroquinolones, as well as stay at the ICU were independent risk factor for CDAD.
Authors: Luis Furuya-Kanamori; Samantha J McKenzie; Laith Yakob; Justin Clark; David L Paterson; Thomas V Riley; Archie C Clements Journal: PLoS One Date: 2015-03-16 Impact factor: 3.240
Authors: Eric Ochoa-Hein; José Sifuentes-Osornio; Alfredo Ponce de León-Garduño; Pedro Torres-González; Víctor Granados-García; Arturo Galindo-Fraga Journal: PLoS One Date: 2018-05-29 Impact factor: 3.240
Authors: Yu Ling Lee-Tsai; Rodrigo Luna-Santiago; Roberta Demichelis-Gómez; Alfredo Ponce-de-León; Eric Ochoa-Hein; Karla María Tamez-Torres; María T Bourlon; Christianne Bourlon Journal: Blood Res Date: 2019-06-25