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1.
Article | IMSEAR | ID: sea-188770

ABSTRACT

Clostridium difficile is a gram positive spore forming bacilli which can be normally present in human colon in some individuals. It can cause clostridium difficile infection which can lead to Clostridium difficile associated disease(CDAD) which is manifested by diarrhoea and in fulminant cases by pseudomembranous colitis and can lead to death. Disruption of normal intestinal flora by antimicrobials and lowering of immunity leads to its overgrowth and disease manifestations. Aims And Objectives: 1. To find the prevalence of clostridium difficile in stool samples of patients presenting with antibiotic associated diarrhoea. 2. To find the risk factors associated with the disease. Methods: The study was conducted from January 2017 to June 2018 on 131 stools samples of patients who developed diarrhoea after three days of starting antibiotics by ELISA based method for detection of Toxin A/B. Results: Out of 131 stool samples analysed, 6 samples (4.58%)were found to be positive for toxin A/B. Correlation between use of third generation cephalosporin and toxin positivity was found to be insignificant. Significant correlation was found between use of chemotherapeutic agents and toxin positivity. It was also found that advanced age was also significant risk factor for development of CDAD. Conclusion: The present study proves that Cdifficile should be kept in mind as an etiological agent in cases of antibiotic associated diarrhoea. Risk factors include advancing age, use of chemotherapeutic agents and antibiotic exposure. To prevent C difficile infection, unnecessary use of antibiotics should be stopped and screening of stools for Toxin analysis in cases of antibiotic associated diarrhoea should be done so that it can be diagnosed and treatment isstarted at the earliest.

2.
The Korean Journal of Gastroenterology ; : 5-12, 2009.
Article in Korean | WPRIM | ID: wpr-102228

ABSTRACT

Antibiotics-associated diarrhea (AAD) is defined as unexplained diarrhea that occurs with the administration of antibiotics. Approximately 20% AAD cases are due to Clostridium difficile. Over the last decade, the incidence of Clostridium difficile-associated disease (CDAD) has progressively increased, and now a significant clinical problem. Recent change in the epidemiology of CDAD and the emergence of an epidemic hypervilruent strain suggest the need for greater attention for infection control, early diagnosis, and more effective treatment modality. However, since most cases of CDAD are both iatrogenic and nosocomial, careful selection of antibiotics, combined with proper hand hygiene and precaution by medical staffs are required.


Subject(s)
Humans , Anti-Bacterial Agents/adverse effects , Clostridioides difficile , Diarrhea/etiology , Enterocolitis, Pseudomembranous/diagnosis , Immunotherapy , Recurrence
3.
The Korean Journal of Gastroenterology ; : 13-19, 2009.
Article in Korean | WPRIM | ID: wpr-102227

ABSTRACT

BACKGROUND/AIMS: The spectrum of Clostridium difficile-associated disease (CDAD) ranges from mild diarrhea to life-threatening colitis. Recent studies reported an increase in incidence and severity of CDAD and the presence of severe community-acquired CDAD (CA-CDAD). The aims of this study were to investigate the incidence of CA-CDAD and non-antibiotics-associated CDAD, and to compare the clinical characteristics between hospital-acquired (HA) and CA-CDAD. METHODS: The medical records of 86 patients who were diagnosed as CDAD in Hanyang University Guri Hospital between January 2005 and October 2007 were retrospectively reviewed. RESULTS: Of the 86 patients (mean age 64 years), 53 patients were women. The most frequently prescribed antibiotics were cephalosporins (67.4%), followed by aminoglycosides (38.4%) and quinolones (14%). Of the 86 patients, the average duration of treatment and recovery time of symptoms were 11.5 days and 4.6 days, respectively. Seven percent of patients experienced relapse treatment. The overall incidence rate of CA-CDAD and non-antibiotics-associated CDAD were 10.5% and 22.1%, respectively. CA-CDAD group had lower rate of antimicrobial exposure whilst showing higher rate of complications compared to HA-CDAD group. Three patients in the CA-CDAD progressed towards a severe complicated clinical course, including septic shock. CONCLUSIONS: The incidence rate of CA-CDAD and non-antibiotics-associated CDAD were 10.5% and 22.1%, respectively. CA-CDAD tends to have a higher complication rate compared to HA-CDAD. Community clinicians needs to maintain a high level of suspicion for CDAD, whilst coping with the ever evolving epidemiologic change.


Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Aminoglycosides/therapeutic use , Anti-Bacterial Agents/therapeutic use , Bacterial Toxins/analysis , Cephalosporins/therapeutic use , Clostridioides difficile , Community-Acquired Infections/epidemiology , Cross Infection/epidemiology , Enterocolitis, Pseudomembranous/diagnosis , Enterotoxins/analysis , Metronidazole/therapeutic use , Quinolones/therapeutic use , Retrospective Studies
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