Clostridium difficile: a problem of concern in developed countries and still a mystery in Latin America

Balassiano, Ilana Teruszkin; Yates, Edwin A.; Domingues, Regina Maria Cavalcanti Pilotto; Ferreira, Eliane de Oliveira

doi:10.1099/jmm.0.037077-0

Cited by 66 publications

(42 citation statements)

References 66 publications

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“…In the same review, the authors concluded with the recommendation for a monitoring plan for C. difficile infections in hospital and community settings in Thailand and other Asian countries [62]. The same observation has been made for Latin America, where little data are available regarding the epidemiology of C. difficile in hospitals, and increased awareness and vigilance among healthcare professionals and the general public seem essential [63]. In an epidemiological study of C. difficile-associated diarrhoea in a Peruvian hospital, the reported overall incidence per 1000 admissions was 12.9.…”

Section: Difficile Outside Europe and North Americamentioning

confidence: 99%

Clostridium difficile infection: Early history, diagnosis and molecular strain typing methods

Rodríguez

Broeck

Taminiau

et al. 2016

Microbial Pathogenesis

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a b s t r a c tRecognised as the leading cause of nosocomial antibiotic-associated diarrhoea, the incidence of Clostridium difficile infection (CDI) remains high despite efforts to improve prevention and reduce the spread of the bacterium in healthcare settings. In the last decade, many studies have focused on the epidemiology and rapid diagnosis of CDI. In addition, different typing methods have been developed for epidemiological studies. This review explores the history of C. difficile and the current scope of the infection. The variety of available laboratory tests for CDI diagnosis and strain typing methods are also examined.

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Section: Difficile Outside Europe and North Americamentioning

confidence: 99%

Clostridium difficile infection: Early history, diagnosis and molecular strain typing methods

Rodríguez

Broeck

Taminiau

et al. 2016

Microbial Pathogenesis

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“…Currently, Clostridium diffi cile infection (CDI) is recognized as the main cause of nosocomial diarrhea. In the last few years, the emergence of highly virulent strains of C. diffi cile in several countries 1 and cases in outpatients with no history of antibiotic therapy have been reported, demonstrating the need for further studies related to the diagnosis and control of this pathogen 2 .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of three enzyme immunoassays and a nucleic acid amplification test for the diagnosis of Clostridium difficile-associated diarrhea at a university hospital in Brazil

Silva

Vilela

Neves

et al. 2014

Rev. Soc. Bras. Med. Trop.

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Introduction:Despite the known importance of Clostridium diffi cile as a nosocomial pathogen, few studies regarding Clostridium diffi cile infection (CDI) in Brazil have been conducted. To date, the diagnostic tests that are available on the Brazilian market for the diagnosis of CDI have not been evaluated. The aim of this study was to compare the performances of four commercial methods for the diagnosis of CDI in patients from a university hospital in Brazil. Methods: Three enzyme immunoassays (EIAs) and one nucleic acid amplifi cation test (NAAT) were evaluated against a cytotoxicity assay (CTA) and toxigenic culture (TC). Stool samples from 92 patients with suspected CDI were used in this study. Results: Twenty-fi ve (27.2%) of 92 samples were positive according to the CTA, and 23 (25%) were positive according to the TC. All EIAs and the NAAT test demonstrated sensitivities between 59 and 68% and specifi cities greater than 91%. Conclusions: All four methods exhibited low sensitivities for the diagnosis of CDI, which could lead to a large number of false-negative results, an increased risk of cross-infection to other patients, and overtreatment with empirical antibiotics.

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“…Other parts of the world, including South America, appear to be spared from C. difficile infections, although the very small number of reported cases from South America may be partially due to lack of diagnostic testing (3). In the Far East, some countries, such as Japan and Korea, have recognized for some time that C. difficile is a significant cause of nosocomial infections (4,5).…”

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confidence: 99%

Molecular Epidemiology of Clostridium difficile Infection in a Major Chinese Hospital: an Underrecognized Problem in Asia?

et al. 2013

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Clostridium difficile infection is almost unrecognized in mainland China. We have undertaken a study in a large Chinese teaching hospital in Changsha, Hunan, China, to identify cases of C. difficile, record patient characteristics, and define the molecular epidemiology with respect to ribotype distribution and cross-infection. Between April 2009 and February 2010, we examined fecal samples from 70 hospitalized patients with diarrhea who were receiving or had received antibiotics within the previous 6 weeks. Clinical information was collected and the samples were cultured for C. difficile retrospectively. Isolates were ribotyped, and multiple-locus variable-number tandem-repeat assay (MLVA) subtyping was performed on clusters of the same ribotype. The mean age of patients from whom C. difficile was cultured was 58 years, with only 4/21 patients aged >65 years. All patients, with a single exception, had received a third-generation cephalosporin and/or a quinolone antibiotic. Twenty-one isolates of C. difficile were recovered, and seven different ribotypes were identified, the dominant types being 017 (48%), 046 (14%), and 012 (14%). We identified two clusters of cross-infection with indistinguishable isolates of ribotype 017, with evidence of spread both within and between wards. We have identified C. difficile as a possibly significant problem, with cross-infection and a distinct ribotype distribution, in a large Chinese hospital. C. difficile may be underrecognized in China, and further epidemiological studies across the country together with the introduction of routine diagnostic testing are needed to ascertain the size of this potentially significant problem.

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Clostridium difficile: a problem of concern in developed countries and still a mystery in Latin America

Cited by 66 publications

References 66 publications

Clostridium difficile infection: Early history, diagnosis and molecular strain typing methods

Clostridium difficile infection: Early history, diagnosis and molecular strain typing methods

Evaluation of three enzyme immunoassays and a nucleic acid amplification test for the diagnosis of Clostridium difficile-associated diarrhea at a university hospital in Brazil

Molecular Epidemiology of Clostridium difficile Infection in a Major Chinese Hospital: an Underrecognized Problem in Asia?

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