Antibiotic-associated diarrhea: Clinical characteristics and the presence of Clostridium difficile.
OBJECTIVE
Evidence in Colombia and Latin America has been insufficient for establishing the clinical characteristics of patients with antibiotic-associated diarrhea (AAD). The present study attempts to describe the clinical characteristics of patients with AAD and to determine the presence of Clostridium difficile, utilizing the polymerase chain reaction (PCR) technique.


METHODS
Forty-three patients with AAD, managed at the Hospital Universitario San Ignacio in Bogotá, Colombia, were evaluated. Prospective patient information was collected, with respect to demographic characteristics, profile of the antibiotic management received, clinical manifestations, risk factors, and paraclinical reports. In addition, the real time PCR test for Clostridium difficile (Cepheid Xpert®, Sunnyvale, CA, United States) was performed.


RESULTS
Patient mean age was 58 years (19.31 SD). The majority of the patients received 2 or more antibiotics (62.9%) and the beta-lactams were the most frequently used. Hospital stay ranged from 2 to 104 days with a median of 10 days. The most frequent clinical manifestations were abdominal pain and bloating, followed by fever and tachycardia. At the time of diagnosis, 23 patients had noninflammatory results in the stool sample analyses and 18 had kidney failure. The mean level of albumin was 2.4mg/dl (0.7 SD). The presence of Clostridium difficile was documented through PCR in 6 patients (13.95% of the cases).


CONCLUSIONS
AAD patients were characterized by a high frequency of severe comorbidities and prolonged hospital stay. The presence of Clostridium difficile in only 13.9% of the cases suggests that other causes of diarrhea in the hospitalized patient should be considered.
Departamento de Medicina Interna, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia.
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A
Rodríguez-Varón
Departamento de Medicina Interna, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia. Electronic address: o.munoz@javeriana.edu.co.
O M
OM
Muñoz
Departamento de Medicina Interna, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia.
J
J
Pulido-Arenas
Departamento de Medicina Interna, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia.
S B
SB
Amado
Departamento de Medicina Interna, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia.
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Tobón-Trujillo
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D016360:Clostridioides difficile; D003967:Diarrhea / Q000209:etiology* / Q000382:microbiology*; D004761:Enterocolitis, Pseudomembranous / Q000209:etiology / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011446:Prospective Studies
D000900:Anti-Bacterial Agents
Antibiotics; Antibióticos; Clostridium difficile; Diarrea; Diarrhea; Polymerase chain reaction; Reacción en cadena de la polimerasa