PMID- 21553102
OWN - NLM
STAT- MEDLINE
DCOM- 20111013
LR  - 20220318
IS  - 0975-0711 (Electronic)
IS  - 0254-8860 (Linking)
VI  - 30
IP  - 2
DP  - 2011 Mar
TI  - Prevalence and clinical course of Clostridium difficile infection in a 
      tertiary-care hospital: a retrospective analysis.
PG  - 89-93
LID - 10.1007/s12664-011-0097-5 [doi]
AB  - The spectrum of Clostridium difficile-associated diarrhea (CDAD) is changing. 
      Apart from antibiotic use, other risk factors such as use of proton pump 
      inhibitors (PPI) and immunosuppressive agents, intensive care unit (ICU) stay and 
      inflammatory bowel disease are being recognized. We retrospectively analyzed data 
      on patients whose stool samples were tested for C. difficile toxin (CDT) by 
      enzyme linked immunosorbent assay between June 2006 and May 2008. Demographic and 
      clinical data, and risk factors (antibiotic use, underlying malignancy, 
      chemotherapy, use of PPI, ICU stay) were noted. The details of treatment for 
      CDAD, response, complication and follow up were recorded. Patients whose stool 
      samples were CDT-positive were grouped as study subjects and those with negative 
      stool samples were included in the control group. Of the 99 patients (mean age 
      46.7 years; 58 men) whose stool samples were tested during this period, 17 (17%) 
      were positive for CDT. As compared with control subjects (n = 82), study subjects 
      were more likely to have fever, prolonged ICU stay, underlying malignancy, and 
      exposure to immunosuppressive and chemotherapeutic agents. On multivariate 
      analysis, exposure to immunosuppressive agents was the only risk factor 
      associated with CDAD. Fifteen patients were treated with metronidazole and two 
      with vancomycin. Two patients did not respond to metronidazole but responded to 
      vancomycin. No patient developed any complication. The prevalence of C. difficile 
      toxin in diarrheal stools sent for C. difficile toxin testing was 17%. Exposure 
      to immunosuppressive agents was a risk factor for the infection. Metronidazole 
      was effective in a majority of patients.
FAU - Ingle, Meghraj
AU  - Ingle M
AD  - Division of Gastroenterology, P D Hinduja National Hospital and Medical Research 
      Center, Veer Savarkar Marg, Mumbai, 400 016, India.
FAU - Deshmukh, Abhijit
AU  - Deshmukh A
FAU - Desai, Devendra
AU  - Desai D
FAU - Abraham, Philip
AU  - Abraham P
FAU - Joshi, Anand
AU  - Joshi A
FAU - Rodrigues, Camilla
AU  - Rodrigues C
FAU - Mankeshwar, Ranjit
AU  - Mankeshwar R
LA  - eng
PT  - Journal Article
DEP - 20110507
PL  - India
TA  - Indian J Gastroenterol
JT  - Indian journal of gastroenterology : official journal of the Indian Society of 
      Gastroenterology
JID - 8409436
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Bacterial Toxins)
RN  - 140QMO216E (Metronidazole)
RN  - 6Q205EH1VU (Vancomycin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anti-Bacterial Agents/*therapeutic use
MH  - Bacterial Toxins/analysis
MH  - Case-Control Studies
MH  - *Clostridioides difficile
MH  - Clostridium Infections/drug therapy/*epidemiology
MH  - Diarrhea/drug therapy/*epidemiology
MH  - Enzyme-Linked Immunosorbent Assay
MH  - Feces/microbiology
MH  - Female
MH  - Hospitals, General
MH  - Humans
MH  - India/epidemiology
MH  - Male
MH  - Metronidazole/therapeutic use
MH  - Middle Aged
MH  - Prevalence
MH  - Retrospective Studies
MH  - Vancomycin/therapeutic use
EDAT- 2011/05/10 06:00
MHDA- 2011/10/14 06:00
CRDT- 2011/05/10 06:00
PHST- 2010/07/23 00:00 [received]
PHST- 2011/04/15 00:00 [accepted]
PHST- 2011/05/10 06:00 [entrez]
PHST- 2011/05/10 06:00 [pubmed]
PHST- 2011/10/14 06:00 [medline]
AID - 10.1007/s12664-011-0097-5 [doi]
PST - ppublish
SO  - Indian J Gastroenterol. 2011 Mar;30(2):89-93. doi: 10.1007/s12664-011-0097-5. 
      Epub 2011 May 7.