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A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
Published on: May 25, 2017
Increasing rates of Clostridium difficile infection in Mexican hospitals
Laura Palau Dávila1, Elvira Garza-González2, Patricia Rodríguez-Zulueta3
1Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González, Hospital de Epidemología, Monterrey, Mexico.
Introduction:
The epidemiology of Clostridium difficile infection (CDI) has changed in the last two decades. There is a lack of information regarding incidence and severity of CDI, especially in the developing world.
Methods:
This was a retrospective and observational study from four hospitals of three Mexican cities. Patients were diagnosed with CDI when presented with loose stools and had at least one of the following tests positive: toxins assay, real-time PCR, or an endoscopic image compatible with pseudomembranous colitis. CDI was classified according to international guidelines. Demographic and clinical data as well as information regarding total hospital admissions, total length-of-hospital stay, and other variables related to hospitalization were gathered from the epidemiology and administration departments of each hospital.
Results:
A total of 2050 hospital beds were analyzed with 288,171 patients hospitalized accumulating 1,576,446 days of hospitalization during the study period. The average rate of CDI per 1000 hospital-days was lower than the rates reported in the US and Europe, although in 2015 CDI rates were almost persistently above the mean rate for the study period. More than half of PCR positive patients were ribotype 027.
Conclusion:
Hospital rates of CDI are increasing in Mexican hospitals with a predominance of infections caused by ribotype 027.
Insights
Clostridium difficile infection (CDI) rates are rising in Mexican hospitals, with a growing prevalence of the concerning ribotype 027. This highlights an urgent need for enhanced surveillance and control measures.
Area of Science:
- Infectious Diseases
- Epidemiology
- Hospital-Acquired Infections
Background:
- Clostridium difficile infection (CDI) epidemiology has shifted globally over the past 20 years.
- Limited data exists on CDI incidence and severity in developing nations.
- Understanding regional variations in CDI is crucial for effective public health strategies.
Purpose of the Study:
- To investigate the incidence and trends of Clostridium difficile infection (CDI) in Mexican hospitals.
- To characterize the prevalent Clostridium difficile strains, including ribotype 027.
- To provide essential epidemiological data from a developing country context.
Main Methods:
- Retrospective, observational study across four hospitals in three Mexican cities.
- Patient diagnosis of CDI based on symptoms and positive diagnostic tests (toxins assay, PCR, or endoscopy).
- Data collection included hospital-wide admissions, length of stay, and patient demographics.
Main Results:
- Analysis of 288,171 hospitalizations over 1,576,446 hospital-days.
- Average CDI rates per 1000 hospital-days were lower than in the US and Europe.
- CDI rates in 2015 exceeded the study period's mean, with over half of PCR-positive cases identified as ribotype 027.
Conclusions:
- Hospital-acquired Clostridium difficile infection rates are increasing in Mexico.
- Ribotype 027 is the predominant strain causing CDI in the studied Mexican hospitals.
- Findings underscore the need for targeted interventions and surveillance for CDI in Mexico.
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