Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospital
Background: Clostridium difficile infections caused by the NAP1/B1/027 strain are more severe, difficult to treat, and frequently associated with relapses. Methods: A case–control study was designed to examine a C. difficile infection (CDI) outbreak over a 12-month period in a Mexican hospital. T...
| Autores principales: | , , , , , , , , , |
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| Formato: | Artículo |
| Lenguaje: | inglés |
| Publicado: |
2016
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| Acceso en línea: | http://eprints.uanl.mx/14877/1/85.pdf |
| _version_ | 1824414173323329536 |
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| author | Morfín Otero, Rayo Garza González, Elvira Aguirre Diaz, Sara Alejandra Escobedo Sanchez, Rodrigo Esparza Ahumada, Sergio Pérez Gómez, Héctor Raúl Petersen Morfin, Santiago Gonzalez Diaz, Esteban E. Martínez Meléndez, Adrián Rodríguez Noriega, Eduardo |
| author_facet | Morfín Otero, Rayo Garza González, Elvira Aguirre Diaz, Sara Alejandra Escobedo Sanchez, Rodrigo Esparza Ahumada, Sergio Pérez Gómez, Héctor Raúl Petersen Morfin, Santiago Gonzalez Diaz, Esteban E. Martínez Meléndez, Adrián Rodríguez Noriega, Eduardo |
| author_sort | Morfín Otero, Rayo |
| collection | Repositorio Institucional |
| description | Background: Clostridium difficile infections caused by the NAP1/B1/027 strain are more severe,
difficult to treat, and frequently associated with relapses.
Methods: A case–control study was designed to examine a C. difficile infection (CDI) outbreak
over a 12-month period in a Mexican hospital. The diagnosis of toxigenic CDI was confirmed
by real-time polymerase chain reaction, PCR (Cepheid Xpert C. difficile/Epi).
Results: During the study period, 288 adult patients were evaluated and 79 (27.4%) patients
had confirmed CDI (PCR positive). C. difficile strain NAP1/B1/027 was identified in 31 (39%) of
the patients with confirmed CDI (240 controls were included). Significant risk factors for CDI
included any underlying disease (p < 0.001), prior hospitalization (p < 0.001), and antibiotic
(p < 0.050) or steroid (p < 0.001) use. Laboratory abnormalities included leukocytosis (p < 0.001)
and low serum albumin levels (p < 0.002). Attributable mortality was 5%. Relapses occurred
in 10% of patients. Risk factors for C. difficile NAP1/B1/027 strain infections included prior
use of quinolones (p < 0.03).
Risk factors for CDI caused by non-027 strains included chronic cardiac disease (p < 0.05),
chronic renal disease (p < 0.009), and elevated serum creatinine levels (p < 0.003). Deaths and
relapses were most frequent in the 027 group (10% and 19%, respectively).
Conclusions: C. difficile NAP1/BI/027 strain and non-027 strains are established pathogens in
our hospital. Accordingly, surveillance of C. difficile infections is now part of our nosocomial
prevention program. |
| format | Article |
| id | eprints-14877 |
| institution | UANL |
| language | English |
| publishDate | 2016 |
| record_format | eprints |
| spelling | eprints-148772021-08-11T14:42:57Z http://eprints.uanl.mx/14877/ Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospital Morfín Otero, Rayo Garza González, Elvira Aguirre Diaz, Sara Alejandra Escobedo Sanchez, Rodrigo Esparza Ahumada, Sergio Pérez Gómez, Héctor Raúl Petersen Morfin, Santiago Gonzalez Diaz, Esteban E. Martínez Meléndez, Adrián Rodríguez Noriega, Eduardo Background: Clostridium difficile infections caused by the NAP1/B1/027 strain are more severe, difficult to treat, and frequently associated with relapses. Methods: A case–control study was designed to examine a C. difficile infection (CDI) outbreak over a 12-month period in a Mexican hospital. The diagnosis of toxigenic CDI was confirmed by real-time polymerase chain reaction, PCR (Cepheid Xpert C. difficile/Epi). Results: During the study period, 288 adult patients were evaluated and 79 (27.4%) patients had confirmed CDI (PCR positive). C. difficile strain NAP1/B1/027 was identified in 31 (39%) of the patients with confirmed CDI (240 controls were included). Significant risk factors for CDI included any underlying disease (p < 0.001), prior hospitalization (p < 0.001), and antibiotic (p < 0.050) or steroid (p < 0.001) use. Laboratory abnormalities included leukocytosis (p < 0.001) and low serum albumin levels (p < 0.002). Attributable mortality was 5%. Relapses occurred in 10% of patients. Risk factors for C. difficile NAP1/B1/027 strain infections included prior use of quinolones (p < 0.03). Risk factors for CDI caused by non-027 strains included chronic cardiac disease (p < 0.05), chronic renal disease (p < 0.009), and elevated serum creatinine levels (p < 0.003). Deaths and relapses were most frequent in the 027 group (10% and 19%, respectively). Conclusions: C. difficile NAP1/BI/027 strain and non-027 strains are established pathogens in our hospital. Accordingly, surveillance of C. difficile infections is now part of our nosocomial prevention program. 2016 Article PeerReviewed text en cc_by_nc_nd http://eprints.uanl.mx/14877/1/85.pdf http://eprints.uanl.mx/14877/1.haspreviewThumbnailVersion/85.pdf Morfín Otero, Rayo y Garza González, Elvira y Aguirre Diaz, Sara Alejandra y Escobedo Sanchez, Rodrigo y Esparza Ahumada, Sergio y Pérez Gómez, Héctor Raúl y Petersen Morfin, Santiago y Gonzalez Diaz, Esteban E. y Martínez Meléndez, Adrián y Rodríguez Noriega, Eduardo (2016) Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospital. The Brazilian Journal of Infectious Diseases, 20 (1). pp. 8-13. ISSN 14138670 http://doi.org/10.1016/j.bjid.2015.09.008 doi:10.1016/j.bjid.2015.09.008 |
| spellingShingle | Morfín Otero, Rayo Garza González, Elvira Aguirre Diaz, Sara Alejandra Escobedo Sanchez, Rodrigo Esparza Ahumada, Sergio Pérez Gómez, Héctor Raúl Petersen Morfin, Santiago Gonzalez Diaz, Esteban E. Martínez Meléndez, Adrián Rodríguez Noriega, Eduardo Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospital |
| thumbnail | https://rediab.uanl.mx/themes/sandal5/images/online.png |
| title | Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospital |
| title_full | Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospital |
| title_fullStr | Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospital |
| title_full_unstemmed | Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospital |
| title_short | Clostridium difficile outbreak caused by NAP1/BI/027 strain and non-027 strains in a Mexican hospital |
| title_sort | clostridium difficile outbreak caused by nap1 bi 027 strain and non 027 strains in a mexican hospital |
| url | http://eprints.uanl.mx/14877/1/85.pdf |
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