The Impact of Recurrent Clostridium difficile Infection on Patients' Prevention Behaviors.

OBJECTIVE To determine the impact of recurrent Clostridium difficile infection (RCDI) on patient behaviors following illness. METHODS Using a computer algorithm, we searched the electronic medical records of 7 Chicago-area hospitals to identify patients with RCDI (2 episodes of CDI within 15 to 56 days of each other). RCDI was validated by medical record review. Patients were asked to complete a telephone survey. The survey included questions regarding general health, social isolation, symptom severity, emotional distress, and prevention behaviors. RESULTS In total, 119 patients completed the survey (32%). On average, respondents were 57.4 years old (standard deviation, 16.8); 57% were white, and ~50% reported hospitalization for CDI. At the time of their most recent illness, patients rated their diarrhea as high severity (58.5%) and their exhaustion as extreme (30.7%). Respondents indicated that they were very worried about getting sick again (41.5%) and about infecting others (31%). Almost 50% said that they have washed their hands more frequently (47%) and have increased their use of soap and water (45%) since their illness. Some of these patients (22%-32%) reported eating out less, avoiding certain medications and public areas, and increasing probiotic use. Most behavioral changes were unrelated to disease severity. CONCLUSION Having had RCDI appears to increase prevention-related behaviors in some patients. While some behaviors are appropriate (eg, handwashing), others are not supported by evidence of decreased risk and may negatively impact patient quality of life. Providers should discuss appropriate prevention behaviors with their patients and should clarify that other behaviors (eg, eating out less) will not affect their risk of future illness. Infect Control Hosp Epidemiol. 2017;38:1351-1357.

Clostridium difficile: causes and interventions.

Human infection with Clostridium difficile can take many forms. It can exist in many patients who are relatively well or who have symptoms similar to irritable bowel syndrome. It can also infect the patient in the acute care facility. These patients typically have received antibiotics for more than 3 days and begin to experience foul-smelling, watery stools within a few days of initiation of antibiotic coverage. Good hand washing and environmental cleanliness remain the primary ways of preventing the spread of this infection from patient to patient. The possibility of using probiotics to replace the beneficial bacteria should be pursued.

Obstrucción intestinal en el recién nacido / Bowel obstruction in newborns

La obstrucción intestinal en los niños reviste mayor importancia en el periodo neonatal ya que es en esta etapa de la vida cuando su frecuencia es más alta. La causa de la infección congénita y su diagnóstico debe sospecharse aun antes del nacimiento del niño. Los síntomas son característicos, el vómito, la distención abdominal, y el deterioro general del paciente son los datos más importantes. Entre los estudios radiológicos el que tiene mayor relevancia es el del colon por enema. El tratamiento oportuno y adecuado determina el mejor pronóstico para la vida y la función intestinal en estos pacientes.