Dávila Laura Palau, Garza-González Elvira, Rodríguez-Zulueta Patricia, Morfín-Otero Rayo, Rodríguez-Noriega Eduardo, Vilar-Compte Diana, Rodríguez-Aldama Juan C, Camacho-Ortiz Adrián
Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González, Hospital de Epidemología, Monterrey, Mexico.
Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González, Departamento of Gastroenterología, Monterrey, Mexico.
Braz J Infect Dis. 2017 Sep-Oct;21(5):530-534. doi: 10.1016/j.bjid.2017.05.007. Epub 2017 Jun 20.
The epidemiology of Clostridium difficile infection (CDI) has changed in the last two decades. There is a lack of information regarding incidence and severity of CDI, especially in the developing world.
This was a retrospective and observational study from four hospitals of three Mexican cities. Patients were diagnosed with CDI when presented with loose stools and had at least one of the following tests positive: toxins assay, real-time PCR, or an endoscopic image compatible with pseudomembranous colitis. CDI was classified according to international guidelines. Demographic and clinical data as well as information regarding total hospital admissions, total length-of-hospital stay, and other variables related to hospitalization were gathered from the epidemiology and administration departments of each hospital.
A total of 2050 hospital beds were analyzed with 288,171 patients hospitalized accumulating 1,576,446 days of hospitalization during the study period. The average rate of CDI per 1000 hospital-days was lower than the rates reported in the US and Europe, although in 2015 CDI rates were almost persistently above the mean rate for the study period. More than half of PCR positive patients were ribotype 027.
Hospital rates of CDI are increasing in Mexican hospitals with a predominance of infections caused by ribotype 027.
艰难梭菌感染（CDI）的流行病学在过去二十年中发生了变化。关于CDI的发病率和严重程度，尤其是在发展中世界，缺乏相关信息。
这是一项对墨西哥三个城市的四家医院进行的回顾性观察研究。当患者出现腹泻且以下至少一项检测呈阳性时，即被诊断为CDI：毒素检测、实时聚合酶链反应（PCR）或与伪膜性结肠炎相符的内镜图像。CDI根据国际指南进行分类。从每家医院的流行病学和管理部门收集人口统计学和临床数据，以及有关医院总入院人数、总住院时间和其他与住院相关变量的信息。
在研究期间，共分析了2050张医院床位，288,171名患者住院，累计住院天数达1,576,446天。每1000个住院日的CDI平均发生率低于美国和欧洲报告的发生率，尽管在2015年CDI发生率几乎持续高于研究期间的平均发生率。超过一半的PCR阳性患者为核糖体分型027。
墨西哥医院的CDI医院发生率正在上升，以核糖体分型027引起的感染为主。
