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Multicenter study on Clostridioides difficile infections in Mexico: exploring the landscape

Daniel De-la-Rosa-Martinez1,2, Diana Vilar-Compte1, Nancy Martínez-Rivera1

  • 1Instituto Nacional de Cancerología, Mexico City, Mexico.

Infection Control and Hospital Epidemiology
|October 21, 2024
PubMed
Abstract

Insights

Clostridioides difficile infection (CDI) remains a significant concern in Mexican hospitals, with healthcare-associated cases being most common. Disparities in incidence between public and private facilities highlight the need for targeted surveillance and interventions.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Public Health

Background:

  • Clostridioides difficile infection (CDI) poses a substantial threat in healthcare settings globally.
  • Understanding CDI trends and outcomes is crucial for effective infection control, especially during pandemics like COVID-19.
  • Mexican healthcare facilities face unique challenges in managing CDI due to varying resources and protocols.

Purpose of the Study:

  • To analyze Clostridioides difficile infection (CDI) trends and patient outcomes in Mexican healthcare facilities.
  • To investigate the impact of the COVID-19 pandemic on CDI epidemiology and associated mortality.
  • To identify risk factors for 30-day all-cause mortality in CDI patients within the Mexican context.

Main Methods:

  • An observational study of case series was conducted across 16 public and private healthcare institutions in Mexico from 2016 to 2022.
  • Demographic, clinical, and laboratory data were collected from 2,356 CDI patients.
  • Incidence rates and risk factors for 30-day mortality were analyzed using multivariate logistic regression.

Main Results:

  • A total of 2,356 CDI cases were identified, with 90% being healthcare-associated.
  • Common comorbidities included hypertension, diabetes, and cancer, with frequent prior use of proton-pump inhibitors, steroids, and antibiotics.
  • The 30-day mortality rate was 16% (371 patients), with risk factors including high Charlson score, steroid use, leukopenia, hypoalbuminemia, septic shock, and SARS-CoV-2 coinfection.
  • Healthcare-associated CDI incidence remained stable (4.78 cases/10,000 patient days) but was higher in public hospitals.

Conclusions:

  • Routine epidemiology surveillance and standardized CDI classification protocols are essential in Mexican healthcare institutions.
  • While CDI rates are comparable to some European countries, significant disparities exist between public and private sectors.
  • Targeted interventions are necessary to address the varying burden of CDI across different healthcare settings in Mexico.

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