Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon.
Sci Rep. 2020 Mar 30;10(1):5678. doi: 10.1038/s41598-020-62418-9.
Clostridium difficile infection (CDI) is becoming a cause of community-acquired diarrhea. The aim is to describe (CDI) as a cause of acute diarrhea in patients presenting from the community to the Emergency Department (ED) of a tertiary care center in Lebanon. A retrospective study conducted in the ED at the American University of Beirut Medical Center (AUBMC). Adult patients presenting with the chief complaint of diarrhea and having positive CDI by stool laboratory testing (toxins A and B), during a three-year period were included. 125 patients with CDI were included. Average age was 61.43 (±20.42) with roughly equal sex prevalence. 30% (n = 36) of patients had neither antibiotic exposure nor recent hospitalization prior to current CDI. Mortality was 9.6% (n = 12), CDI was attributed as the cause in 16.7% (n = 2) and a contributing factor in 41.6% (n = 5). Recurrence within 3 months occurred in 9.6% (n = 11) in mainly those taking Proton Pump Inhibitors (PPIs) and having multiple co-morbidities. There is a high rate of community acquired CDI in Lebanon. Review of patients' medications (PPIs and antibiotics) is crucial. More studies are needed to assess mortality associated with CDI and the outcome of coinfection with other enteric pathogens.
艰难梭菌感染（CDI）正成为社区获得性腹泻的一个原因。本研究旨在描述黎巴嫩一家三级护理中心的急诊科（ED）中，CDI 是社区就诊患者急性腹泻的一个病因。本研究为在贝鲁特美国大学医学中心（AUBMC）ED 进行的一项回顾性研究。纳入了在三年期间因粪便实验室检测（毒素 A 和 B）阳性而出现腹泻主诉并确诊 CDI 的成年患者。共纳入 125 例 CDI 患者。平均年龄为 61.43（±20.42）岁，性别比例大致相等。30%（n=36）的患者在当前 CDI 之前既无抗生素暴露也无近期住院史。死亡率为 9.6%（n=12），CDI 被归因于病因的占 16.7%（n=2），作为促成因素的占 41.6%（n=5）。3 个月内复发的有 9.6%（n=11），主要发生在服用质子泵抑制剂（PPIs）且合并多种合并症的患者中。黎巴嫩有很高的社区获得性 CDI 发生率。审查患者的药物（PPIs 和抗生素）非常关键。需要更多的研究来评估 CDI 相关死亡率以及与其他肠道病原体合并感染的结果。
