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Clostridium difficile-associated diarrhoea.

N Wight1, H Curtis, J Hyde

  • 1Division of Gastroenterology, University Hospital, Queen's Medical Centre, Nottingham, UK.

Postgraduate Medical Journal
|April 10, 1999
PubMed
Summary
This summary is machine-generated.

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Clostridium difficile-associated diarrhea (CDAD) cases surged due to multiple antibiotic use. Metronidazole did not prevent CDAD, and multiple stool samples are recommended for accurate diagnosis.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Clinical Medicine

Background:

  • Significant increase in Clostridium difficile-associated diarrhoea (CDAD) cases observed, rising from 29 in 1993 to 210 in 1995.
  • CDAD is a serious healthcare-associated infection often linked to antibiotic use.

Purpose of the Study:

  • To investigate the association between antibiotic usage patterns and the rise in CDAD at a hospital.
  • To evaluate the efficacy of metronidazole in preventing CDAD.
  • To assess the diagnostic accuracy of initial stool sample testing for C. difficile cytotoxin.

Main Methods:

  • Retrospective analysis of case notes for 110 patients diagnosed with CDAD during the first six months of 1995.
  • Review of patient antibiotic history, including the number and types of antibiotics received.

Related Experiment Videos

  • Analysis of C. difficile cytotoxin test results from stool samples, noting timing and any delays in diagnosis.

    • Main Results:

    • A high prevalence of prior antibiotic exposure was noted in 106 out of 110 CDAD patients.
    • Forty-six patients received three or more different antibiotics, and 28 had received metronidazole.
    • Nineteen patients had initial negative stool samples for C. difficile cytotoxin, with an average delay of 8.2 days for a positive result.

    Conclusions:

    • Multiple antibiotic usage is strongly associated with the increased incidence of CDAD.
    • Metronidazole does not appear to protect against C. difficile colonization or subsequent diarrhoea.
    • Recommending the submission of multiple stool samples for C. difficile cytotoxin testing to improve diagnostic sensitivity.