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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Nagging Presence of Clostridium difficile Associated Diarrhoea in North India DC06-DC09
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Nagging Presence of Clostridium difficile Associated Diarrhoea in North India DC06-DC09

机译：印度北部难辨梭状芽胞杆菌相关腹泻的存在DC06-DC09

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Introduction: Clostridium Difficile Associated Diarrhoea (CDAD) is a significant cause of morbidity in hospitalised patients worldwide. The data on clinical epidemiology of this disease in Indian subcontinent is scarce.Aim: To evaluate the risk factors and clinical course of patients with CDAD.Materials and Methods: A cross-sectional study was planned at our tertiary care centre, All India Institute of Medical Sciences, whereby, all patients who had nosocomial diarrhea between 2010 and 2014 were included in the study. Their clinical and laboratory profile were recorded using structured questionnaire and their stool samples were subjected to ELISA for detection of toxins A and B (Premier toxins A and B). Those patients who had toxins A and B in their stool samples were diagnosed as CDAD. The clinical and laboratory profile of CDAD patients were further analysed.Results: A total of 791 patients with nosocomial diarrhea were included in this study. CDAD was diagnosed in a total of 48 patients (6%). The year wise breakdown of the positive patients is as follows: 7/135 (5.2%), 4/156 (2.6%), 5/141 (3.5%), 9/193 (4.7%) and 23/166 (13.8%) respectively. A total of 16/48 (34%) of CDAD cases belonged to the age group of 51-60 years. Malignancy (n=15, 31.25%) was the most common underlying pathological condition. All the patients had a history of antibiotic intake. Most common antibiotic used in the patients of CDAD was third generation cephalosporins (n=27, 56.25%). The use of clindamycin, carbapenems and colistin increased in the year 2014. Mean duration of hospital stay was 9.8 days. Diarrhoea was associated with fever in 50% of the patients while abdominal pain was seen in 39.6% of the patients.Conclusion: The control of Clostridium difficile infection suffers from the rampant use of higher antibiotics. There is a need for proper implementation of antimicrobial stewardship programmes and better hospital infection control to stop the transmission of this nagging bug.
机译：简介：艰难梭菌相关性腹泻（CDAD）是全球住院患者发病的重要原因。在印度次大陆，该疾病的临床流行病学数据很少。目的：评估CDAD患者的危险因素和临床病历。材料与方法：计划在我们全印度研究所三级护理中心进行横断面研究。研究纳入了2010年至2014年间所有医院内腹泻的患者。使用结构化调查表记录其临床和实验室概况，并对粪便样本进行ELISA以检测毒素A和B（高级毒素A和B）。粪便样本中含有毒素A和B的患者被诊断为CDAD。结果：本研究共纳入791例院内腹泻患者。总共48位患者（6％）被诊断出CDAD。阳性患者的年度细分如下：7/135（5.2％），4/156（2.6％），5/141（3.5％），9/193（4.7％）和23/166（13.8％） ） 分别。共有16/48（34％）个CDAD病例属于51-60岁年龄组。恶性肿瘤（n = 15，31.25％）是最常见的潜在病理状况。所有患者都有抗生素摄入史。 CDAD患者中最常用的抗生素是第三代头孢菌素（n = 27，56.25％）。 2014年，克林霉素，碳青霉烯和粘菌素的使用量有所增加。平均住院时间为9.8天。 50％的病人腹泻与发烧相关，39.6％的病人出现腹痛。结论：艰难梭菌感染的控制受到较高抗生素使用的困扰。需要适当实施抗菌素管理计划和更好的医院感染控制，以阻止这种na虫的传播。

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