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Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatán

2007, Number 2

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Rev Biomed 2007; 18 (2)

Clostridium perfringens and Clostridium difficile as etiological agents of antibiotic associated diarrhea in Costa Rican children

Ruiz-Corella MA, Altamirano-Silva P, Rodríguez-Cavallini E, Gamboa-Coronado MM

Language: Spanish
References: 31
Page: 81-87
PDF size: 264.41 Kb.


ABSTRACT

Introduction. Nosocomial diarrhea may be caused by the use of antibiotics that alter the indigenous microbiota and favor the colonization of pathogens. Clostridium difficile, a Gram positive spore-forming anaerobe, is considered a frequent etiological agent; recently, C. perfringens has also been implicated and may act, synergically with C. difficile. The present study describes the prevalence of these bacteria in a group of children with nosocomial diarrhea, an entity that requires precise therapeutic management.
Material and methods. Of the samples of nosocomial diarrheic feces associated to antibiotics from children in a Costa Rican hospital 39 were processed. The presence of toxin A of C. difficile and enterotoxin of C. perfringens was determined. Bacterial isolates were obtained from CCFA and OPSP agar and their antibiotic susceptibility pattern was determined.
Results. Enterotoxin of C. perfringens was detected in 3 (7.7%) and C. perfringens was isolated from 8 (20.5%) of the samples, none was enterotoxigenic. All of the isolates were sensitive to nine antibiotics and resistant to four. C. difficile toxin was detected in 6 (15.4%) samples and the bacterium was isolated in 5 (12.8%). None of the isolates was sensitive to cefoxitin, and some presented resistance to other four antibiotics. In 3 (7.7%) of the samples, C. difficile and C. perfringens were simultaneously isolated, but none was positive for both toxins.
Discussion. Of the nosocomial diarrheas analyzed 23.1% were caused by C. difficile or C. perfringens, anaerobic pathogens that are not included in Costa Rican hospitals as bacteriological routines. These results reveal the importance of implementing techniques for their detection. The antimicrobial sensitivity tests reveal certain degree of resistance that should be considered for accurate treatment. Further studies shall be performed in order to confirm this resistance.


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