Prevalencia y factores relacionados con la infección por Clostridium difficile en un centro hospitalario de alta complejidad  en Cali (Colombia)

Oñate-Gutiérrez, José Millán; Villegas, María Virginia; Correa, Adriana

doi:10.22354/in.v21i1.646

Cited by 4 publications

(2 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our CART showed that if a patient had a history of antibiotic use, the probability of a positive PCR was 45.7%. Previous studies in this matter showed almost all antibiotics can increase vulnerability to CDI, but cephalosporins, fluoroquinolones, clindamycin, and certain penicillins (e.g., amoxicillin/clavulanic acid) increase risk to the greatest extent (8,14,15). Above supports the results of this study regarding consider this exposure in the decision to perform a PCR.…”

Section: Discussionsupporting

confidence: 86%

“…In low and middle-income countries, there is a lack of evidence-based diagnostic algorithms for early CDI diagnosis using a PCR test. In 2011, a study showed that the prevalence of in-hospital C. difficile was 10 per 10.000 inpatients in Cali, indicating a high prevalence of this infection and the need to identified better strategies for the control of C. difficile (14). Our study shows a straightforward algorithm that includes clinically relevant variables and may help clinicians in the diagnostic process of patients with suspected CDI.…”

Section: Discussionmentioning

confidence: 87%

See 1 more Smart Citation

Prediction of Clostridium difficile infection in patients with polymerase chain reaction using a classification and regression tree

Martínez-Ruíz

Parra-Lara

Rosso

2020

Preprint

View full text Add to dashboard Cite

BackgroundClostridium difficile infection (CDI) is commonly diagnosed with the polymerase chain reaction (PCR), but this test finds a high percentage of false positives, so their use and interpretation in CDI is a challenge in the clinical practice. That is why it is necessary to define an algorithm to optimize the use of PCR that considers clinical characteristics to classify patients with diarrhea as CDI or without CDI. ObjectiveTo identify a predictive algorithm with the clinical features that best classify patients with CDI vs. without CDI, to help physicians in making decisions to request PCR. Materials and methodsA case-control study was conducted at Fundación Valle del Lili. The population was inpatients between 2012 and 2016, with 18 or more years, and diarrhea, abdominal pain, or other nonspecific gastrointestinal symptoms who underwent PCR. Cases were defined as patients with positive PCR for C. difficile and as controls patients with negative PCR for C. difficile. Predictive algorithms to classify patients was constructed using a classification tree, classification and regression tree (CART). ResultsA total of 149 patients were included (48 cases with positive PCR and 99 controls with negative PCR). The CART has a high capacity to classify patients with a negative PCR correctly. It includes variables about the history of antibiotics use, the use of proton-pump inhibitor, the use of ranitidine, and the use of antifungal drugs. The CART showed sensitivity 64.6%, specificity 85.8%, positive predictive value 68.8%, negative predictive value 83.3%. and AUC 79.7%.DiscussionCART had good specificity and a high negative predictive value; it could be considered as an algorithm to identify conditions that indicate when it is not necessary to perform a PCR test in a patient symptom of CDI.

show abstract

Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 87%

Prediction of Clostridium difficile infection in patients with polymerase chain reaction using a classification and regression tree

Martínez-Ruíz

Parra-Lara

Rosso

2020

Preprint

View full text Add to dashboard Cite

show abstract

Clostridium difficile-associated Diarrhea in Developing Countries: A Systematic Review and Meta-Analysis

Curcio¹,

Cané²,

Fernández³

et al. 2019

Infect Dis Ther

View full text Add to dashboard Cite

Introduction The prevalence of Clostridium difficile infection is rapidly increasing worldwide, but prevalence is difficult to estimate in developing countries where awareness, diagnostic resources, and surveillance protocols are limited. As diarrhea is the hallmark symptom, we conducted a systematic review and meta-analysis to determine the prevalence and incidence of C. difficile infection in patients in these regions who presented with diarrhea. Methods We conducted a systematic literature search of MEDLINE/PubMed, Scopus, and Latin-American and Caribbean Health Sciences Literature databases to identify and analyze data from recent studies providing prevalence or incidence rates of C. difficile -associated diarrhea in developing countries within four regions: Africa–Middle East, developing Asia, Latin America, and China. Our objectives were to determine the current prevalence and incidence density rates of first episodes of C. difficile -associated diarrhea in developing countries. Results Within the regions included in our analysis, prevalence of C. difficile infection in patients with diarrhea was 15% (95% CI 13–17%) (including community and hospitalized patients), with no significant difference across regions. The incidence of C. difficile infection in 17 studies including this information was 8.5 per 10,000 patient-days (95% CI 5.83–12.46). Prevalence was significantly higher in hospitalized patients versus community patients ( p = 0.0227). Conclusion Our prevalence estimate of 15% is concerning; however, low awareness and inconsistent diagnostic and surveillance protocols suggest this is markedly underestimated. Enhanced awareness and management of C. difficile infection in patients with diarrhea, along with improvements in infection control and surveillance practices, should be implemented to reduce prevalence of C. difficile -associated diarrhea in developing countries. Funding Pfizer Inc. Electronic supplementary material The online version of this article (10.1007/s40121-019-0231-8) contains supplementary material, which is available to authorized users.

show abstract

Clinical epidemiology of Clostridium difficile infection among hospitalized patients with antibiotic-associated diarrhea in a university hospital of Brazil

et al. 2018

View full text Add to dashboard Cite

Prevalencia y factores relacionados con la infección por Clostridium difficile en un centro hospitalario de alta complejidad en Cali (Colombia)

Cited by 4 publications

References 20 publications

Prediction of Clostridium difficile infection in patients with polymerase chain reaction using a classification and regression tree

Prediction of Clostridium difficile infection in patients with polymerase chain reaction using a classification and regression tree

Clostridium difficile-associated Diarrhea in Developing Countries: A Systematic Review and Meta-Analysis

Clinical epidemiology of Clostridium difficile infection among hospitalized patients with antibiotic-associated diarrhea in a university hospital of Brazil

Contact Info

Product

Resources

About