Factores asociados a la infección para Clostridium difficile en un hospital universitario de Bogotá


Autoria(s): Marín, Juliana
Contribuinte(s)

Sierra, Fernando

Data(s)

07/07/2014

Resumo

Introducción La infección por Clostridium difficile, es una de las causas más frecuentes de diarrea nosocomial con una alta morbimortalidad, con un aumento exponencial en su incidencia, en Estados Unidos se duplicó, de 261 casos x 100.000 en 1993 pasó a 546 x 100.000 en 2003 2, y en Canadá se encontraron datos similares con un aumento de 4.5 veces, en 1991 de 35.6 casos x 100.000 a 156.3 casos por 100.000 en 2004 3 . Se han descrito varios factores asociados Materiales y Métodos Se trata de un estudio descriptivo de tipo serie de casos en el que se evaluaron pacientes con diagnóstico de infección por C. Difficile y los factores asociados en un Hospital Universitario entre febrero de 2010 hasta septiembre de 2011 Resultados Se recolectaron 31 pacientes la edad promedio fue de 58 años con un rango entre 18 y 93 años, de los cuales 19 (61%) fueron mujeres y 12 (39%) hombres. El factor asociado a la infección por C. Difficile más frecuentemente encontrado fue el uso de inhibidores de bomba de protones con 54.84% (n=17) .No se encontraron pacientes VIH positivos o con diagnóstico de enfermedad inflamatoria intestinal. Ningún paciente presentó complicaciones asociadas a la infección ni mortalidad alguna. Conclusión El factor asociado que más se presentó fue el uso de antimicrobianos en los quince dias previos al inicio del cuadro en el 74% de los pacientes lo que coincide con lo presentado en la literatura mundial.

Introduction Infection with Clostridium difficile , is one of the most common causes of nosocomial diarrhea with high morbidity and mortality , with an exponential increase in incidence in the United States doubled from 261 cases per 100,000 in 1993 to 546 per 100,000 spent in 2003 2 , and Canada Similar data were found with increased 4.5 times in 1991 to 35.6 cases per 100,000 to 156.3 per 100,000 in 2004 3. Described several factors associated. Materials and Methods This is a descriptive study of case series in which patients with diagnosis of C. difficile infection and associated factors in a University Hospital from February 2010 to September 2011 Results 31 patients were collected , the average age was 58 years, ranging between 18 and 93 years, of which 19 ( 61 %) were women and 12 ( 39 %) men. The factor associated with C. difficile infection most frequently found was the use of proton pump inhibitors with 54.84 % (n = 17). No HIV positive or diagnosed with inflammatory bowel disease patients were found. No patient had complications from infection or some mortality . Conclusion The factor most associated was presented was the use of antimicrobials in the box before the start of the 74 % of patients which is consistent with what was presented in the literatura.

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http://repository.urosario.edu.co/handle/10336/8687

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spa

Publicador

Facultad de Medicina

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info:eu-repo/semantics/openAccess

Fonte

reponame:Repositorio Institucional EdocUR

instname:Universidad del Rosario

Tonna I, Welsby P. Pathogenesis and treatment of Clostridium difficile infection. Postgrad Med J. 2005;81:367-369

O´Connor J, Johnson S, Gerding D. Clostridium difficileinfection caused by the epidemic BI/NAP1/027 Strain. Gastroenterology. 2009; 136:1913-1924.

Bauer M, Kuijper E, Van Dissel J. European society of clinical Microbiology and Infectious Diseases (ESCMID): treatment guidance document for Clostridium difficile infection. Clin Microbiol Infect. 2009;15:1067-1079

Bauer M, Van Dissel J. Alternative strategies for Clostridium difficile infection. International Journal Of Antimicrobial Agents. 2009;33:S51-S56

Ricciardi R, Rothenberger D, Madoff R, et al. Increasing prevalence and severity of Clostridium difficile colitis in hospitalized patients in the United States. Arch Surg 2007;142:624-631

McFarland L. Update on the changing epidemiology of Clostridium difficile – associated disease. Nature Clinical Practice Gastroenterology and Hepatology. 2008;5(1):40-48

Karas J, Enoch D, Aliyu S. A Review of mortality due to Clostridium difficile infection. Journal of infection. 2010;61:1-8

Bartlett J. Clostridium difficile Old and new observations. J Clin Gastroenterol. 2007;41:S24-29

Butala P, Divino C. Surgical aspects of fulminant Clostridium difficile Colitis. The American Journal of Surgery. 2010;200:131-135

Regino WO, González A, Zuleta MG. Prevalence of different types of colitis among the elderly. Rev Col Gastroenterol 2009;24:272-278

Becerra M, Ospina S, León S, Berbesi D. Risk factors for Clostridium difficile infection. Infectio 2011;15:220–6

Starr J. Clostridium difficile associated diarrhea: diagnosis and treatment. British Medical Journal. 2005;331:498-501

Warny M, Pepin J, Fang A, et al. Toxin production by emerging strain of Clostridium difficile associated with outbreaks of severe disease in North America and Europe. Lancet. 2005; 366:1079-1084.

Cookson B. Hipervirulent Strains of Clostridium difficile. Postgrad Med J. 2007;83:291-295.

Hookman P, Barkin J. Review: Clostridium difficile-Associated Disorders/Diarrhea and Clostridium difficile colitis: The emergence of a More virulent Era. 2007. Dig Dis Sci. 2007; 52:1071-1075

Cartman S, Heap J, Kuehne S, et al. The emergence of “hypervirulence” in Clostridium difficile. International Journal of Medical Microbiology. 2010;300:387-395

Cohen S, Gerding D, Johnson S, et al. Clinical Practice Guidelines for Clostridium difficile infection in adults: 2010 Update by society for healthcare epidemiology of America (SHEA) and the infectious diseases society of America (IDSA). Infect Control Hosp Epidemiol. 2010; 31(5):431-455

Missaghi B, Valenti A, Owens R, et al. Clostridium difficile infection: A critical overview. Current Infectious Disease Reports. 2008;10:165-173

Reinert D, Jank T, Aktories K, et al. Structural basis for ther function of Clostridium difficiletoxin B.J Mol Biol. 2005;351:973-981

Deneve C, Janoir C, Polaine I, Fantinato C, et al. New trends in Clostridium difficile virulence and pathogenesis. International Journal of antimicrobial Agents. 2009;33:S24-S28

Diggs N, Surawicz C. Evolving Concepts in Clostridium difficile Colitis. Current Gastroenterology Reports. 2009;11:400-405.

Mathew T, Higginbottom P. Clostridium difficile Infection: Emerging concepts and Treatments. Current Gastroenterology reports. 2008;10:404-408.

Kelly C, LaMont T. Clostridium difficile more difficult than ever. N Engl J Med. 2008;359:1932-1940

McFee R, Abdelsayed G. Clostridium difficile. Dis Mon. 2009;55:439-470.

Cloud J, Kelly C. Update on Clostridium difficile associated disease. Curr Opin Gastroenterol. 2007;23:4-9

Hookman P, Barkin J. Clostridium difficile associated infection, diarrea and colitis. World J Gastroenterol. 2009;15(13):1554-1580.

Fenner L, Widmer A, Goy G, et al. Rapid and reliable diagnostic algorithm for detection of Clostridium difficile. Journal of Clinical Microbiology. 2008;46(1):328-330.

Bartlett J. Clostridium difficile: progress and challenges. Ann N. Y. Acad. Sci. 2010;1213:62-69.

O´Donoghue C, Kyne L. Update on Clostridium difficileinfection. Curr Opin Gastroenterol. 2011;27(1):38-47.

Kuntz J, Chrischilles E, Pendergast J, et al. BMC Infectious Diseases. 2011;11:194-201.

Peterson L, Robicsek A. Does my patient have clostridium difficile infection?. Ann Intern Med. 2009;151:176-179.

Dudukgian H, Sie E, Gonzalez C, et al. C. Difficile - Predictors of fatal outcome. J Gastrointest Surg. 2010;14:315-322.

Weiss K. Clostridium difficile and fluoroquinolones: is there a link?. International Journal of antimicrobial agents. 2009;33:s29-s32

Pant C, Madonia P, Minocha A. Does PPI therapy predispone to Clostridium difficile infection?. Nat Rev Gastroenterol Hepatol. 2009;6:555-557.

Issa M, Ananthakrishnan A, Binion D. Clostridium difficile and inflammatory Bowel disease. Inflamm Bowel Dis. 2008;14:1432-1442.

Ananthakrishnan A, Issa M, Clostridium difficile and inflamatory bowel disease. Gastroenterol Clin N Am. 2009;38:711-728

Owens R. Clostridium difficile-Associated Disease Changing Epidemiology and Implications for Management. Drugs 2007; 67 (4): 487-502.

Leffler D, Lamont T. Treatment of Clostridium difficile –Associated Disease. Gastroenterology. 2009;136:1899-1912

Nelson R, Kelsey P, Leeman H, et al. Antibiotic treatment for Clostridium difficile-associated diarrea in adults. Cochrane Database Syst Rev. 2011 Sep 7;(9):CD004610.

Brunton L, Chabner B, Knollmann B. Goodman and Gilman's The Pharmacological Basis of Therapeutics. Cap VI. Drugs affecting Gastrointestinal function. Edition 12. Ed. McGraw-Hill 2011.

Musher D, Logan N, Hamill R, et al. Nitazoxanide for the treatment of Clostridium difficile colitis. Clin infect Dis. 2006;43:421-427.

Musher D, Logan N, Bressler A, et al. Nitazoxanide versus vancomycin in Clostridium difficile infection: a randomized, double-blind study. Clin Infect Dis.2009; 48(4): e41-6.

Weiss K. Toxin-binding treatment for Clostridium difficile: a review including reports of studies with tolevamer. Int J Antimicrob agents. 2009; 33(1): 4-7.

Cone L, Lopez C, Tarleton H, et al. A durable response to relapsing clostridium difficile Colitis may require combined therapy with High-dose oral vancomycin and intravenous immune globulin. Infect Dis Clin Pract. 2006; 14:217-220.

Hassoun A, Ibrahim F.Use of Intravenous Immunoglobulin for the Treatment of Severe Clostridium difficile Colitis.Am J Geriatr Pharmacother.2007; 5:48-51.

Greenberga R, Marburyb T, Fogliac G, et al. Phase I dose finding studies of an adjuvanted clostridium difficile toxoid vaccine. Vaccine. 2012; 30: 2245–2249

Giannasca P, Warny M. Active and passive immunization against Clostridium difficile diarrhea and colitis. Vaccine. 2004;22: 848–856.

Gough E, Shaik H, Manges A. Systematic review of intestinal microbiota transplantation (fecal bacteriotherapy) for recurrent Clostridium difficile infection. Clin Infect Dis. 2011;53(10):994-1002.

Colleen R, De Leon L, Jasutkar N. Fecal Microbiota Transplantation for Relapsing Clostridium difficile Infection in 26 Patients Methodology and Results. J Clin Gastroenterol 2012;46:145–149

Monaghan T, Boswell T, Mahida Y. Recent avances in Clostridium difficile-associated disease. Gut. 2008;57(6):850 – 860.

Berman L, Carling T, Fitzgerald, et al. Defining Surgical Therapy for pseudomembranous colitis with toxic megacolon. 2008. J Clin Gastoenterol 2008;42:476-480

Shannon-Lowe J, Matheson N, Cooke F, et al. Prevention and medical management of Clostridium difficile infection. BMJ. 2010;340: 641-646.

Kuijper E, van Dissel J, Wilcox M. Clostridium difficile: Changing epidemiology and new treatment options. Curr Opin Infect Dis. 2007;20:376-383.

Shah D, Duc Dhang M, Hasbun R, et al. Clostridium difficileinfection: Update on emerging antibiotic treatment options and antibiotic resistance. Expert Rev Anti Infect Ther. 2010;8(5):555-564

Jabber M, Olafsson S, Fung W, et al. Clinical review of the management of fulminant Clostridium difficile infection. Am J Gastroenterol. 2008;103:3195-3203

Abougergi M, Kwon J. Intravenous Immunoglobulin for treatment of Clostridium difficile infection: a review. Dig Dis Sci. 2011;56:19-26

DECLARACION DE HELSINKI DE LA ASOCIACION MÉDICA MUNDIAL. Principios éticos para las investigaciones médicas en seres humanos http://www.wma.net/es/30publications/10policies/b3/17c_es.pdf. Accesado28/02/2012

RESOLUCION NUMERO 8430 DE 1993. Por la cual se establecen las normas científicas, técnicas y administrativas para la investigación en salud.http://www.minproteccionsocial.gov.co/Normatividad/RESOLUCION%208430%20DE%201993.pdf. Accesado 28/02/2012

TEME

Palavras-Chave #Asepsia #617 #Clostridium difficile #Infección nosocomial #Hospitales #Infecciones intrahospitalarias #Clostridium difficile #diarrhea #nosocomial infection #associated factors
Tipo

info:eu-repo/semantics/bachelorThesis

info:eu-repo/semantics/acceptedVersion