title: [Epidemiology of Clostridium difficile-associated disease (CDAD) in Salamanca].
abstract: BACKGROUND
  Clostridium difficile infection is considered a major cause of nosocomial diarrhoea in developed countries and is increasingly becoming more important as an etiologic agent of community diarrhoea, also in patients without risk factors.
  
  
  METHODS
  Beginning in May 2011, the aim of our study is to know the characteristics of patients suffering from C. difficile Associated Disease in Salamanca University Hospital, collecting their data in a survey conducted for this purpose. A case was defined as a patient with compatible clinical and positive microbiological diagnosis.
  
  
  RESULTS
  After 18 months of study, 41 cases had been documented representing an incidence of 1.15 cases per 10,000 patient-days. Patients were hospitalized (37) or health care associated (4), females (54%), age ≥ 65 years (56%) with prior antibiotic treatment (80%), most had diarrhea after the third day of admission, less than three weeks and without blood. Most were treated with metronidazole alone (78%), 19% with metronidazole and vancomycin, and the remaining percentage was resolved without treatment. Recurrences were about 20% and 7 (17%) died.
  
  
  CONCLUSIONS
  The characteristics of our patients with C. difficile - associated disease are the same as those reported by other authors. Local surveillance is important in order to study the endemic and epidemic C. difficile infection. According to published epidemiological changes, we should be able to develop strategies from the Microbiology laboratories that will improve diagnosis of the disease.
authors.affiliation: Mónica de Frutos-Serna, Servicio de Microbiología. Complejo Asistencial Universitario de Salamanca, Pº de San Vicente 58-182. 37007 Salamanca, Spain. mdefrutossernad@saludcastillayleon.es.
authors.forename: María
authors.initials: M
authors.lastname: Siller-Ruiz
authors.forename: Noelia
authors.initials: N
authors.lastname: Calvo-García
authors.forename: Sara
authors.initials: S
authors.lastname: Hernández-Egido
authors.forename: Ana
authors.initials: A
authors.lastname: María-Blázquez
authors.forename: Mónica
authors.initials: M
authors.lastname: de Frutos-Serna
authors.forename: José Elías
authors.initials: JE
authors.lastname: García-Sánchez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000863:Antacids / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D015897:Comorbidity; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology; D004761:Enterocolitis, Pseudomembranous / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000863:Antacids; D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents; D008795:Metronidazole; D014640:Vancomycin