Cargando…

Clostridioides difficile Diarrhea: An Emerging Problem in a South Indian Tertiary Care Hospital

ContextClostridioides difficile infection (CDI) is one of the most common infectious causes of hospital-acquired diarrhea. The actual burden of the disease is underestimated in India due to inadequate diagnostic methods and limited studies conducted. Aims The aim of this study was to determine the b...

Descripción completa

Detalles Bibliográficos
Autores principales: Kannambath, Rachana, Biswas, Rakhi, Mandal, Jharna, Vinod, Kolar V., Dubashi, Biswajit, Parameswaran, Narayanan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Medical and Scientific Publishers Pvt. Ltd. 2021
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8714319/
https://www.ncbi.nlm.nih.gov/pubmed/34975254
http://dx.doi.org/10.1055/s-0041-1731944
_version_ 1784623890243256320
author Kannambath, Rachana
Biswas, Rakhi
Mandal, Jharna
Vinod, Kolar V.
Dubashi, Biswajit
Parameswaran, Narayanan
author_facet Kannambath, Rachana
Biswas, Rakhi
Mandal, Jharna
Vinod, Kolar V.
Dubashi, Biswajit
Parameswaran, Narayanan
author_sort Kannambath, Rachana
collection PubMed
description ContextClostridioides difficile infection (CDI) is one of the most common infectious causes of hospital-acquired diarrhea. The actual burden of the disease is underestimated in India due to inadequate diagnostic methods and limited studies conducted. Aims The aim of this study was to determine the burden and risk factors of CDI among patients with hospital-acquired diarrhea. Methods and Materials Stool specimen of patients (age > 1 year) with hospital-acquired diarrhea were screened for glutamate dehydrogenase antigen and toxin using an enzyme immunoassay. If both antigen and toxin were present, it was reported as positive for toxigenic CDI. Samples positive for antigen and negative for toxin were further tested with Cepheid GeneXpert assay for detecting the toxin producing gene. Results Of 75 patients (mean age 36.07 ± 20.79, 64% males), 14 (18.67%) patients were positive for toxigenic Clostridioides difficile ( C. difficile ) and 3 (4%) patients were nontoxigenic C. difficile . Addition of GeneXpert to the testing algorithm increased the yield of toxin detection in 5/14 patients who were negative by toxin assay. On analysis of risk factors, prolonged hospital stay was found to have significant association ( p -value = 0.022). Patients with factors like intensive care unit stay, presence of diabetes mellitus as a comorbidity, and exposure to antibiotics like carbapenems and glycopeptides have been found to have a higher prevalence of CDI. Conclusions The prevalence of CDI in our population was 18.67% and the major risk factor associated was prolonged hospital stay. The addition of GeneXpert for the detection of toxin gene increased the yield from 12 to 18.68%.
format Online
Article
Text
id pubmed-8714319
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Thieme Medical and Scientific Publishers Pvt. Ltd.
record_format MEDLINE/PubMed
spelling pubmed-87143192021-12-30 Clostridioides difficile Diarrhea: An Emerging Problem in a South Indian Tertiary Care Hospital Kannambath, Rachana Biswas, Rakhi Mandal, Jharna Vinod, Kolar V. Dubashi, Biswajit Parameswaran, Narayanan J Lab Physicians ContextClostridioides difficile infection (CDI) is one of the most common infectious causes of hospital-acquired diarrhea. The actual burden of the disease is underestimated in India due to inadequate diagnostic methods and limited studies conducted. Aims The aim of this study was to determine the burden and risk factors of CDI among patients with hospital-acquired diarrhea. Methods and Materials Stool specimen of patients (age > 1 year) with hospital-acquired diarrhea were screened for glutamate dehydrogenase antigen and toxin using an enzyme immunoassay. If both antigen and toxin were present, it was reported as positive for toxigenic CDI. Samples positive for antigen and negative for toxin were further tested with Cepheid GeneXpert assay for detecting the toxin producing gene. Results Of 75 patients (mean age 36.07 ± 20.79, 64% males), 14 (18.67%) patients were positive for toxigenic Clostridioides difficile ( C. difficile ) and 3 (4%) patients were nontoxigenic C. difficile . Addition of GeneXpert to the testing algorithm increased the yield of toxin detection in 5/14 patients who were negative by toxin assay. On analysis of risk factors, prolonged hospital stay was found to have significant association ( p -value = 0.022). Patients with factors like intensive care unit stay, presence of diabetes mellitus as a comorbidity, and exposure to antibiotics like carbapenems and glycopeptides have been found to have a higher prevalence of CDI. Conclusions The prevalence of CDI in our population was 18.67% and the major risk factor associated was prolonged hospital stay. The addition of GeneXpert for the detection of toxin gene increased the yield from 12 to 18.68%. Thieme Medical and Scientific Publishers Pvt. Ltd. 2021-07-09 /pmc/articles/PMC8714319/ /pubmed/34975254 http://dx.doi.org/10.1055/s-0041-1731944 Text en The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Kannambath, Rachana
Biswas, Rakhi
Mandal, Jharna
Vinod, Kolar V.
Dubashi, Biswajit
Parameswaran, Narayanan
Clostridioides difficile Diarrhea: An Emerging Problem in a South Indian Tertiary Care Hospital
title Clostridioides difficile Diarrhea: An Emerging Problem in a South Indian Tertiary Care Hospital
title_full Clostridioides difficile Diarrhea: An Emerging Problem in a South Indian Tertiary Care Hospital
title_fullStr Clostridioides difficile Diarrhea: An Emerging Problem in a South Indian Tertiary Care Hospital
title_full_unstemmed Clostridioides difficile Diarrhea: An Emerging Problem in a South Indian Tertiary Care Hospital
title_short Clostridioides difficile Diarrhea: An Emerging Problem in a South Indian Tertiary Care Hospital
title_sort clostridioides difficile diarrhea: an emerging problem in a south indian tertiary care hospital
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8714319/
https://www.ncbi.nlm.nih.gov/pubmed/34975254
http://dx.doi.org/10.1055/s-0041-1731944
work_keys_str_mv AT kannambathrachana clostridioidesdifficilediarrheaanemergingprobleminasouthindiantertiarycarehospital
AT biswasrakhi clostridioidesdifficilediarrheaanemergingprobleminasouthindiantertiarycarehospital
AT mandaljharna clostridioidesdifficilediarrheaanemergingprobleminasouthindiantertiarycarehospital
AT vinodkolarv clostridioidesdifficilediarrheaanemergingprobleminasouthindiantertiarycarehospital
AT dubashibiswajit clostridioidesdifficilediarrheaanemergingprobleminasouthindiantertiarycarehospital
AT parameswarannarayanan clostridioidesdifficilediarrheaanemergingprobleminasouthindiantertiarycarehospital