Sally Alzouby1, Kamran Baig2, Fahad Alrabiah3, Atef Shibl4, Daifallah Al-Nakhli2, Abiola C Senok5. 1. Department of Microbiology and Immunology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; Infection Control Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia. 2. Infection Control Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia. 3. Department of Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. 4. Department of Microbiology and Immunology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia. Electronic address: ashibl@alfaisal.edu. 5. College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
Abstract
BACKGROUND: Significant increase in rates of Clostridioides difficile associated diarrhea (CDI) has been reported globally but there remains a paucity of data from Saudi Arabia. METHODOLOGY: Prospective hospital-based surveillance for CDI using the Center for Disease Control (CDC) criteria was conducted from June to November 2015 in a tertiary healthcare facility in Riyadh, Saudi Arabia. RESULTS: During the surveillance period, 106 episodes of CDI were identified among 59 patients in 137,230 patient-days. The incidence of CDI was 3.5 per 10,000 patient days. Of the 106 episodes, 58% (n=61) were new cases, 12% (n=13) were recurrent cases and 30% (n=32) were duplicate cases. Majority of the new cases (n/N=43/61; 70%) were healthcare onset, followed by community onset (21%) and 8% were community-onset healthcare associated. No statistically significant change in trend was observed during the surveillance period. The most prevalent CDI risk factor was use of proton pump inhibitor (PPI) (92%) followed by prolonged use of antibiotics (77%). Pareto-analysis indicated that controlling for PPI use, prolong and multiple antibiotic exposure and prolonged hospitalization results in 80% CDI reduction. CONCLUSION: The findings indicate a low incidence of CDI. Multicenter studies are needed to elucidate the burden to CDI in the country.
BACKGROUND: Significant increase in rates of Clostridioides difficile associated diarrhea (CDI) has been reported globally but there remains a paucity of data from Saudi Arabia. METHODOLOGY: Prospective hospital-based surveillance for CDI using the Center for Disease Control (CDC) criteria was conducted from June to November 2015 in a tertiary healthcare facility in Riyadh, Saudi Arabia. RESULTS: During the surveillance period, 106 episodes of CDI were identified among 59 patients in 137,230 patient-days. The incidence of CDI was 3.5 per 10,000 patient days. Of the 106 episodes, 58% (n=61) were new cases, 12% (n=13) were recurrent cases and 30% (n=32) were duplicate cases. Majority of the new cases (n/N=43/61; 70%) were healthcare onset, followed by community onset (21%) and 8% were community-onset healthcare associated. No statistically significant change in trend was observed during the surveillance period. The most prevalent CDI risk factor was use of proton pump inhibitor (PPI) (92%) followed by prolonged use of antibiotics (77%). Pareto-analysis indicated that controlling for PPI use, prolong and multiple antibiotic exposure and prolonged hospitalization results in 80% CDI reduction. CONCLUSION: The findings indicate a low incidence of CDI. Multicenter studies are needed to elucidate the burden to CDI in the country.
Authors: Nehad J Ahmed; Abdul Haseeb; Emad M Elazab; Hamed M Kheir; Azmi A Hassali; Amer H Khan Journal: Saudi Pharm J Date: 2021-08-04 Impact factor: 4.330