Althaqafi Abdulhakeem, Munshi Adeeb, Baghlaf Bayan, Munshi Enas, Malakah Manar, Almarhabi Hassan, Alharbi Maher, Alsaedi Asim
King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Department of Internal Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia; Department of Infectious Diseases, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia.
King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Department of Internal Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia; Department of Infectious Diseases, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia.
J Infect Public Health. 2022 Oct;15(10):1037-1042. doi: 10.1016/j.jiph.2022.08.009. Epub 2022 Aug 27.
Clostridium difficile is an anaerobic gram-positive spore-forming bacillus that is most commonly associated with nosocomial diarrhea. This study aimed to analyze the prevalence and risk factors of Clostridium difficile infection (CDI) at a tertiary health care center, Western region, Saudi Arabia. We also aimed to examine the duration of exposure to each risk factor prior CDI development, and to categorize CDI as severe and non-severe depending on the white blood cell (WBC) count. Various complications of the infection were also analyzed.
We performed a retrospective chart review of all patients who had a positive nucleic acid amplification test (NAAT) for Clostridium difficile toxin genes between October 2018 and October 2020.
The prevalence of CDI among the included patients was 9.1% (237 of 2611 patients). The mean age (standard deviation) was 56.86 (21) years, and the infection was more prevalent among men (52.74%) than among women (47.26%). The most common risk factor associated with CDI was recent antibiotic use (74.68%), followed by recent acid suppressant use (67.50%), malignancy (46%), and previous gastrointestinal surgery (6.30%). The CDI recurrence rate was 13.90%. Piperacillin-tazobactam was the most frequently used broad-spectrum antibiotic, and was used in 38.8% of the patients, followed by meropenem. The most common malignancy type was lymphoma (22.94%, n = 25), followed by leukemia (n = 23). The most common type of surgery was subtotal colectomy (n = 6). Three patients underwent transverse colon resection, and two underwent ileocecal resection. Hypotension was the most frequently recorded complication (28.40%) in the study population.
The prevalence rate of CDI among the study patients during the two-year study from October 2018 to October 2020 was 9.1%. Appropriate use of antibiotic and acid suppressants, and contact isolation measures can help in decreasing the number of CDI cases.
艰难梭菌是一种厌氧革兰氏阳性产芽孢杆菌，最常与医院获得性腹泻相关。本研究旨在分析沙特阿拉伯西部地区一家三级医疗中心艰难梭菌感染（CDI）的患病率及危险因素。我们还旨在研究CDI发生前各危险因素的暴露持续时间，并根据白细胞（WBC）计数将CDI分为严重和非严重两类。此外，还分析了感染的各种并发症。
我们对2018年10月至2020年10月期间艰难梭菌毒素基因核酸扩增试验（NAAT）呈阳性的所有患者进行了回顾性病历审查。
纳入患者中CDI的患病率为9.1%（2611例患者中的237例）。平均年龄（标准差）为56.86（21）岁，感染在男性中（52.74%）比在女性中（47.26%）更普遍。与CDI相关的最常见危险因素是近期使用抗生素（74.68%），其次是近期使用抑酸剂（67.50%）、恶性肿瘤（46%）和既往胃肠道手术（6.३०%）。CDI复发率为13.90%。哌拉西林-他唑巴坦是最常用的广谱抗生素，38.8%的患者使用过，其次是美罗培南。最常见的恶性肿瘤类型是淋巴瘤（22.94%，n = 25），其次是白血病（n = 23）。最常见的手术类型是结肠次全切除术（n = 6）。3例患者接受了横结肠切除术，2例接受了回盲部切除术。低血压是研究人群中最常记录的并发症（28.40%）。
在2018年10月至2020年10月的两年研究期间，研究患者中CDI的患病率为9.1%。合理使用抗生素和抑酸剂以及接触隔离措施有助于减少CDI病例数。
