title: [Survey with three epidemiological markers after 22 cases of diarrhea caused by Clostridium difficile in a geriatric hospital].
abstract: In a geriatric hospital of Saint-Etienne (Charité), among 153 patients having presented a nosocomial diarrhea from September 1990 to August 1991 Clostridium difficile (C.d.) has been isolated in 22 cases. Two of the nine units of the hospital had the highest incidence rates: 4.6 and 3.7%. In the faeces of 16 patients, C.d. was toxinogenic. In all cases, except one, antibiotic preceded diarrhea. Amoxicillin + clavulanic acid treatment was the most frequently responsible (65%). For detecting an eventual outbreak, several epidemiologic markers were evaluated: Clindamycin MIC, protein profiles, serotyping. Clindamycin susceptibility differentiated two Cd. types, but has no epidemiologic value. Protein profiles, performed by SDS-Page, individualized 6 different profiles, but 10 strains gave no classifiable profiles. Serotyping, applied by M. Delmée, appeared as the most interesting marker. Inquiry allowed to eliminate an outbreak but revealed two episodes of cross contaminations in the 3 units, 2 of them having the highest incidence rates. Markers proved persistence of the same C.d. strain in some patients who were correctly treated by metronidazole.
authors.affiliation: Service de Bactériologie, CHRU, Hôpital Bellevue, Saint-Etienne, France.
authors.forename: A C
authors.initials: AC
authors.lastname: Vautrin
authors.forename: S
authors.initials: S
authors.lastname: Enck
authors.forename: G
authors.initials: G
authors.lastname: Antoniotti
authors.forename: A
authors.initials: A
authors.lastname: Sedallian
authors.forename: M F
authors.initials: MF
authors.lastname: Odelin
authors.forename: G
authors.initials: G
authors.lastname: Dorche
authors.forename: G
authors.initials: G
authors.lastname: Aubert
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000517:prevention & control; D001426:Bacterial Proteins / Q000032:analysis; D001427:Bacterial Toxins / Q000032:analysis; D002981:Clindamycin / Q000494:pharmacology; D016360:Clostridioides difficile / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology*; D003967:Diarrhea / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D004761:Enterocolitis, Pseudomembranous / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D012189:Retrospective Studies; D012703:Serotyping
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D001427:Bacterial Toxins; D008795:Metronidazole; D002981:Clindamycin
vernacular_title: Enquête a l'aide de trois marqueurs épidémiologiques après 22 diarrhées a Clostridium difficle dans un hôpital gériatrique.