title: Clostridium difficile: a problem of concern in developed countries and still a mystery in Latin America.
abstract: Clostridium difficile-associated disease (CDAD) is caused by a spore-forming bacterium and can result in highly variable disease, ranging from mild diarrhoea to severe clinical manifestations. Infections are most commonly seen in hospital settings and are often associated with on-going antibiotic therapy. Incidences of CDAD have shown a sustained increase worldwide over the last ten years and a hypervirulent C. difficile strain, PCR ribotype 027/REA type BI/North American pulsed-field (NAP) type 1 (027/BI/NAP-1), has caused outbreaks in North America and Europe. In contrast, only a few reports of cases in Latin America have been published and the hypervirulent strain 027/BI/NAP-1 has, so far, only been reported in Costa Rica. The potential worldwide spread of this infection calls for epidemiological studies to characterize currently circulating strains and also highlights the need for increased awareness and vigilance among healthcare professionals in currently unaffected areas, such as Latin America. This review attempts to summarize reports of C. difficile infection worldwide, especially in Latin America, and aims to provide an introduction to the problems associated with this pathogen for those countries that might face outbreaks of epidemic strains of C. difficile for the first time in the near future.
authors: Leptospira Collection, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.|WHO Collaborating Center for Leptospirosis, Oswaldo Cruz Foundation, Pavilhão Rocha Lima, 302 Manguinhos, Rio de Janeiro 21040-360, Brazil.
authors: I T
authors: IT
authors: Balassiano
authors: School of Biological Sciences, University of Liverpool, Liverpool L69 7ZB, UK.
authors: E A
authors: EA
authors: Yates
authors: Universidade Federal do Rio de Janeiro, CCS, Bloco I, 2° andar, Laboratório de Biologia de Anaeróbios, Rio de Janeiro 20941-901, Brazil.
authors: R M C P
authors: RMCP
authors: Domingues
authors: Universidade Federal do Rio de Janeiro, CCS, Bloco I, 2° andar, Laboratório de Biologia de Anaeróbios, Rio de Janeiro 20941-901, Brazil.
authors: E O
authors: EO
authors: Ferreira
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects; D016360:Clostridioides difficile / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000453:epidemiology* / Q000382:microbiology*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D019049:Developed Countries; D003906:Developing Countries; D004196:Disease Outbreaks; D005060:Europe / Q000453:epidemiology; D005838:Genotype; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D058889:Molecular Typing; D009656:North America / Q000453:epidemiology; D000091402:Prohibitins
chemical_list: D000900:Anti-Bacterial Agents; C000717331:PHB2 protein, human; D000091402:Prohibitins