title: Epidemiology of Clostridium difficile: a hospital-based descriptive study in Argentina and Mexico.
abstract: A prospective study was conducted in four tertiary hospitals in Argentina and Mexico in order to describe the occurrence of Clostridium difficile infection (CDI) in these settings. The objective was to evaluate the incidence of CDI in at-risk populations in Argentina (one center) and Mexico (three centers) and to further explore potential study sites for vaccine development in this region. A prospective, descriptive, CDI surveillance study was conducted among hospitalized patients aged ≥40 years who had received ≥48h of antibiotic treatment. Stool samples were collected from those with diarrhea within 30 days after starting antibiotics and analyzed for toxins A and B by ELISA, and positive samples were further tested by toxinogenic culture and restriction endonuclease analysis type assay. Overall, 466 patients were enrolled (193 in Argentina and 273 in Mexico) of whom 414 completed the follow-up. Of these, 15/414 (3.6%) experienced CDI episodes occurring on average 18.1 days after admission to hospital and 15.9 days after the end of antibiotics treatment. The incidence rate of CDI was 3.1 (95% CI 1.7-5.2) per 1000 patient-days during hospitalization, and 1.1 (95% CI 0.6-1.8) per 1000 patient-days during the 30-day follow-up period. This study highlighted the need for further evaluation of the burden of CDI in both countries, including the cases occurring after discharge from hospital.
authors.affiliation: Hospital Municipal Prof. Dr. Bernardo Houssay, de Vicente Lopez, Buenos Aires, Argentina.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Lopardo
authors.affiliation: Antiguo Hospital Civil de Guadalajara "Fray Antonio Alcalde", Guadalajara, Jalisco, Mexico.
authors.forename: Rayo
authors.initials: R
authors.lastname: Morfin-Otero
authors.affiliation: Hospital de Alta Especialidad de Veracruz "Virgilio Uribe", Veracruz, Mexico.
authors.forename: Iliana Isabel
authors.initials: II
authors.lastname: Moran-Vazquez
authors.affiliation: Sanofi Pasteur, Swiftwater, USA.
authors.forename: Fernando
authors.initials: F
authors.lastname: Noriega
authors.affiliation: Sanofi Pasteur, Montevideo, Uruguay.
authors.forename: Betzana
authors.initials: B
authors.lastname: Zambrano
authors.affiliation: Sanofi Pasteur, Lyon, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Luxemburger
authors.affiliation: Sanofi Pasteur, Swiftwater, USA.
authors.forename: Ginamarie
authors.initials: G
authors.lastname: Foglia
authors.affiliation: Sanofi Pasteur, México City, Mexico. Electronic address: enrique.rivas@sanofipasteur.com.
authors.forename: Enrique Eduardo
authors.initials: EE
authors.lastname: Rivas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001118:Argentina / Q000453:epidemiology; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000453:epidemiology*; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D011159:Population Surveillance; D011446:Prospective Studies
keywords: Clostridium infections; Epidemiology; Incidence; Latin America