Clostridium difficile infection frequency in patients with nosocomial infections or using antibiotics.
OBJECTIVE
Clostridium difficile is the most common cause of nosocomial infectious diarrhea. The frequency of colonization in hospitalized patients varies between 10 and 43%.


METHODS
Clostridium difficile common antigen was investigated in stool samples of 50 patients who developed nosocomial diarrhea (group 1), 65 outpatients who attended the clinic after development of diarrhea during antibiotic use (group 2), 18 patients with active chronic inflammatory bowel disease (group 3), and 30 control patients were studied. The Latex agglutination test and the toxin A was performed to investigate the presence of the Clostridium difficile common antigen in stool samples. The possible predisposing factors for nosocomial infection were analyzed.


RESULTS
Clostridium difficile common antigen was found positive in 27.7% and 14% of group 2 and group 1, respectively while negative in stools of patients with inflammatory bowel disease. Asymptomatic fecal Clostridium difficile carriage in healthy volunteers was 3.3%. The antibiotic that induced diarrhea the most was clindamycin in group 1, and ampicillin-sulbactam in group 2. Enema was found to be the most important risk factor for C. difficile in hospitalized patients.


CONCLUSIONS
The Clostridium difficile common antigen was detected more frequently in antibiotic-associated diarrhea patients than in nosocomial diarrhea patients. Clostridium difficile-associated diarrhea was also more frequent in immunosuppressive patients with uremia and diabetes mellitus.
Gursoy
Sebnem
S
Department of Gastroenterology, Erciyes University School of Medicine, Kayseri, Turkey. sgursoy@erciyes.edu.tr
Guven
Kadri
K
Arikan
Tamer
T
Yurci
Alper
A
Torun
Edip
E
Baskol
Mevlut
M
Ozbakir
Omer
O
Yucesoy
Mehmet
M
D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D000942:Antigens, Bacterial / Q000737:chemistry; D001427:Bacterial Toxins / Q000737:chemistry; D002908:Chronic Disease; D016360:Clostridioides difficile / Q000378:metabolism*; D003015:Clostridium Infections / Q000175:diagnosis*; D003428:Cross Infection / Q000175:diagnosis* / Q000382:microbiology*; D003967:Diarrhea / Q000382:microbiology; D005243:Feces; D006801:Humans; D007124:Immunoenzyme Techniques; D007249:Inflammation; D015212:Inflammatory Bowel Diseases / Q000276:immunology; D007841:Latex Fixation Tests; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000942:Antigens, Bacterial; D001427:Bacterial Toxins