medigraphic.com
ISSN 0016-3813 (Print)

2009, Number 3

<< Back Next >>

Gac Med Mex 2009; 145 (3)

Enfermedad asociada a Clostridium difficile en América Latina

Camacho-Ortiz A, Ponce-de-León A, Sifuentes-Osornio J

Language: Spanish
References: 55
Page: 223-229
PDF size: 84.88 Kb.


ABSTRACT

Clostridium difficile associated disease (CDAD) has shown a sustained increase worldwide over the last ten years. However, there are few studies on this topic in Latin America. We conducted a comprehensive literature review using medical databases of Latin American countries. We found only seven recent papers in which clinical characteristics and risk factors were analyzed; some included outcome variables. Of these articles, only one was prospective, while the rest were either retrospective, cross-sectional or case-control studies. Most studies were done among hospitalized adult patients, even though patients 13+ years were also included in some reports. Only two recent clinical studies used cell culture to determine a cytopathic effect and the rest included immonoenzymatic assays. In general, all the studies we reviewed showed that the use of fluorquinolones, clindamycin, and cephalosporins were the antibiotics mostly associated with CDAD. Treatment schedules generally included metronidazol, although vancomycin was reported in one. Attributable mortality was lower than the mortality described in previous reports from hospitals in developed countries. Studies where this outcome was included did not surpass 4%, a significant difference from the findings from developed countries. In Latin America there are few studies that describe this clinical problem, they generally include small sample sizes and most are retrospective. There is a clear need to design and carry out prospective studies that will allow us to determine the true prevalence of this health problem.


REFERENCES

  1. Bartlett JG. Clinical practice. Antibiotic-associated diarrhea. N Engl J Med 2002;346:334-339.

  2. Aslam S, Musher D. An update on diagnosis, treatment, and prevention of Clostridium difficile-associated disease. Gastroenterol Clin N Am 2006;35:315-335.

  3. Kuijper EJ, van Dissel JT, Wilcox MH. Clostridium difficile: changing epidemiology and new treatment options. Curr Opin Infect Dis 2007;20:376-383.

  4. Kuijper EJ, Coignard B, Tüll P. ESCMID Study Group for Clostridium difficile; EU Member States; European Centre for Disease Prevention and Control. Emergence of Clostridium difficile-associated disease in North America and Europe. Clin Microbiol Infect 2006;12(Suppl 6):2-18.

  5. Smith A. Outbreak of Clostridium difficile infection in an English hospital linked to hypertoxin-producing strains in Canada and the US. Euro Surveill 2005;10:E050630.2.

  6. Report: Death involving MRSA and Clostridium difficile by communal establishment: England and Wales, 2001-06. Health Statistics Quarterly 2008;38(Summer). Disponible en http://www.statistics.gov.uk/statbase/Product.asp?vlnk=6725

  7. Labbé AC, Poirier L, Maccannell D, Louie T, Savoie M, Béliveau C, et al. Clostridium difficile infections in a Canadian tertiary care hospital before and during a regional epidemic associated with the BI/NAP1/027 strain. Antimicrob Agents Chemother 2008;52:3180-3187.

  8. Pépin J, Valiquette L, Cossette B. Mortality attributable to nosocomial Clostridium difficile-associated disease during an epidemic caused by a hypervirulent strain in Quebec. CMAJ 2005;173:1037-1042.

  9. McDonald LC, Owings M, Jernigan DB. Clostridium difficile infection patients discharged from short-stay hospitals, 1996–2003. Emerg Infect Dis 2006;12:409-415.

  10. Loo VG, Poirier L, Miller M, Oughton M, Libman M.D, Michaud S, et al. A predominantly clonal multi-institutional outbreak of Clostridium difficile-associated diarrhea with high morbidity and mortality. N Engl J Med 2005;353:2442-2449.

  11. Centers for Disease Control. Data and statistics about Clostridium difficile infections. Disponible en http://www.cdc.gov/ncidod/dhqp/id_Cdiff_data.html

  12. Pépin J, Saheb N, Coulombe MA, Alary ME, Corriveau MP, Authier S, et al. Emergence of fluoroquinolones as the predominant risk factor for Clostridium difficile-associated diarrhea: a cohort study during an epidemic in Quebec. Clin Infect Dis 2005;41:1254-1260.

  13. Muto CA, Pokrywka M, Shutt K, Mendelsohn AB, Nouri K, Posey K, et al. A large outbreak of Clostridium difficile-associated disease with an unexpected proportion of deaths and colectomies at a teaching hospital following increased fluoroquinolone use. Infect Control Hosp Epidemiol 2005;26:273-280.

  14. McFarland LV, Clarridge JE, Beneda HW, Raugi GJ. Fluoroquinolone use and risk factors for Clostridium difficile-associated disease within a veterans administration health care system. Clin Infect Dis 2007;45:1141-1151.

  15. Torres JF, Cedillo R, Sánchez J, Dillman C, Giono S, Muñoz O. Prevalence of Clostridium difficile and its cytotoxin in infants in Mexico. J Clin Microbiol 1984;20: 274-275.

  16. Camorlinga-Ponce M, Gamboa M, Barragan JJ, Munoz O, Fekety FR, Torres JF. Epidemiological aspects of Clostridium difficile in a pediatric hospital and its role in diarrheal disease. Eur J Clin Microbiol 1987;6:542-546.

  17. Zaidi M, Ponce de León S, Ortiz RM, Ponce-de León S, Calva JJ, Ruiz-Palacios G, et al. Hospital-acquired diarrhea in adults: a prospective casecontrolled study in Mexico. Infect Control Hosp Epidemiol 1991;12:349-355.

  18. Sánchez E, Bussalleu A, Finch R, Gilman R, Combe J, Gotuzzo E. Low incidence of pseudomembranous colitis associated with antibiotics at a general hospital in Lima. Rev Esp Enferm Dig 1990;77:120-124.

  19. Organización Panamericana de la Salud. Situación de la salud en las Américas. Indicadores básicos en salud 2007. Disponible en http://www.paho.org/spanish/dd/ais/IB_2007_SPA.pdf

  20. Fernández-Canigia L, Nazar J, Arce M, Dadamio J, Smayevsky J, Bianchini H. Clostridium difficile diarrhea: frequency of detection in a medical center in Buenos Aires, Argentina. Rev Argent Microbiol 2001;33:101-107.

  21. Marcon AP, Gamba MA, Vianna LA. Nosocomial diarrhea in the intensive care unit. Braz J Infect Dis 2006;10:384-389.

  22. Camacho-Ortiz A, Galindo-Fraga A, Lamothe-Molina P, Bobadilla-del-Valle M, Maravilla-Franco E, Sifuentes-Osornio J. Comportamiento clínico de la enfermedad asociada a Clostridium difficile: estudio de casos y controles, XXXIII Congreso Anual de la Asociación Mexicana de Infectología y Microbiología Clínica A. C., León, Guanajuato, México, mayo de 2008. Número de resumen B8.

  23. Herrera PR, Cotera AF, Fica AC, Galdo TA, Alvo MA. Alta incidencia de diarrea por Clostridium difficile en pacientes nefrológicos. Rev Med Chile 2003;131:397-403.

  24. Álvarez ML, González RD, Briceño IL, Cofre CD, Labarca JL, Vial PC, et al. Diagnóstico de diarrea por Clostridium difficile: en busca de un enfoque clínico más eficiente. Rev Med Chile 2001;129:620-625.

  25. Barbut F, Delmee M, Brazier JS, Petit JC, Poxton IR, Rupnik M, et al. A European survey on diagnostic methods and testing protocols for Clostridium difficile. Clin Microbiol Infect 2003;9:989-996.

  26. Guiles J, Critchley I, Sun X. New agents for Clostridium difficile-associated disease. Expert Opin Investig Drugs 2008;17:1671-1683.

  27. Gardilcic M, Fica A, Chang M, Llanos C, Luzoro A. Diarrea asociada a Clostridium difficile en un hospital de adultos. Estudio descriptivo. Rev Chil Infect 2000;17:307-312.

  28. García C, Samalvides F, Vidal M, Gotuzzo E, Dupont H. Epidemiology of Clostridium difficile-associated diarrhea in a Peruvian tertiary care hospital. Am J Trop Med Hyg 2007;77:802-805.

  29. Pasic M, Jost R, Carrel T, Von Segesser L, Turina M. Intracolonic vancomycin for pseudomembranous colitis. N Engl J Med 1993;329:583.

  30. Apisarnthanarak A, Razavi B, Mundy LM. Adjunctive intracolonic vancomycin for severe Clostridium difficile colitis: case series and review of the literature. Clin Infect Dis 2002;35:690-696.

  31. Willingham FF, Ticona-Chávez E, Taylor DN, Bowen AB, Crane AR. Diarrhea and Clostridium difficile infection in Latin American patients with AIDS. Clin Infect Dis 1998;27:487-493.

  32. Heslop OD, King SD, Levett PN, Barton EN, Wynter J. Clostridium difficile infection in immunocompromised patients a three health-care facilities in Jamaica. Octava Conferencia Anual de Investigación, Kingston, 22 de octubre de 1999.

  33. Ruiz-Corella MA, Altamirano-Silva P, Rodríguez-Cavallini E, Gamboa-Coronado M. Clostridium perfringens y Clostridium difficile como agentes etiológicos de diarrea nosocomial asociada a antibióticos en niños costarricenses. Rev Biomed 2007;18:81-87.

  34. Sloan LM, Duresko BJ, Gustafson DR, Rosenblatt JE. Comparison of realtime PCR for detection of the tcdC gene with four toxin immunoassays and culture in diagnosis of Clostridium difficile infection. J Clin Microbiol 2008;46:1996-2001.

  35. Pinto LJ, Alcides AP, Ferreira EO, Avelar KE, Sabrá A, Domingues RM, et al. Incidence and importance of Clostridium difficile in paediatric diarrhoea in Brazil. J Med Microbiol 2003;52:1095-1099.

  36. Ferreira CE, Nakano V, Durigon EL, Ávila-Campos MJ. Prevalence of Clostridium spp. and Clostridium difficile in children with acute diarrhea in São Paulo city, Brazil. Mem Inst Oswaldo Cruz 2003;98:451-454.

  37. Zumbado-Salas R, Gamboa-Coronado Mdel M, Rodríguez-Cavallini E, Chaves-Olarte E. Clostridium difficile in adult patients with nosocomial diarrhea in a Costa Rican hospital. Am J Trop Med Hyg 2008;79:164-165.

  38. Goorhuis A, Legaria M, Harmanus C, Klaassen C, Brazier J, Kuijper E. Application of MLVA to study the spread of Clostridium difficile toxin A-negative strains of PCR ribotype 017 in a general hospital in Buenos Aires, Argentina. Décimo octavo Congreso Europeo de Microbiología Clínica y Enfermedades Infecciosas. Barcelona, España, mayo de 2008. Número de resumen P1476.

  39. Alcides AP, Brazier JS, Pinto LJ, Balassiano IT, Boente RF, de Paula GR. New PCR ribotypes of Clostridium difficile detected in children in Brazil: prevalent types of Clostridium difficile in Brazil. Antonie Van Leeuwenhoek 2007;92:53-59.

  40. Cunha BA. Antibiotic resistance. Med Clin North Am 2000;84:1407-1429.

  41. Liberman JM. Appropriate antibiotic use and why it is important: the challenges of bacterial resistance. Pediatr Infect Dis J 2003;22:1143-1151.

  42. Istúriz RE, Carbon C. Antibiotic use in developing countries. Infect Control Hosp Epidemiol 2000;21:394-397.

  43. Larson E, Lin SX, Gómez-Duarte C. Antibiotic use in Hispanic households, New York city. Emerg Infect Dis 2003;9:1096-1102.

  44. Calva J, Bojalil R. Antibiotic use in a periurban community in Mexico: a household and drugstore survey. Soc Sci Med 1996;42:1121-1128.

  45. Salud en las Américas 2007. Capítulo 4. Las políticas públicas y los sistemas y servicios de salud. Disponible en http://www.paho.org/hia/index.html

  46. Rodríguez-Palacios A, Staempfli HR, Duffield T, Weese JS. Clostridium difficile in retail ground meat, Canada. Emerg Infect Dis 2007;13:485-487.

  47. Collignon P, Wegener HC, Braam P, Butler CD. The routine use of antibiotics to promote animal growth does little to benefit protein undernutrition in the developing world. Clin Infect Dis 2005;41:1007-1013.

  48. Rupnik M. Is Clostridium difficile-associated infection a potentially zoonotic and foodborne disease? Clin Microbiol Infect 2007;13:457-459.

  49. Griggs DJ, M, Hall MC, Jin YF, Piddock LJV. Quinolone resistance in veterinary isolates of Salmonella. J Antimicrob Chemother 1994;33:1173-1189.

  50. Tavechio AT, Ghilardi AC, Peresi JT, Fuzihara TO, Yonamine EK, Jakabi M, et al. Salmonella serotypes isolated from nonhuman sources in São Paulo, Brazil, from 1996 through 2000. J Food Prot 2002;65:1041-1044.

  51. Salud en las Américas 2007. Capítulo 1. Las políticas públicas y los sistemas y servicios de salud. Disponible en http://www.paho.org/hia/index.html

  52. Turgeon DK, Novicki TJ, Quick J, Carlson L, Miller P, Ulness B, y col. Six rapid test for direct detection of Clostridium difficile and its toxins in fecal samples compared with the fibroblast cytotoxicity assay. J Clin Microbiol 2003;41:667-670.

  53. Pépin J. Vancomycin for the treatment of Clostridium difficile infection: For whom is this expensive bullet really magic? Clin Infect Dis 2008;46:1493-1498.

  54. Al-Nassir WN, Sethi AK, Li Y, Pultz MJ, Riggs MM, Donskey CJ. Both oral metronidazole and oral vancomycin promote persistent overgrowth of vancomycin-resistant enterococci during treatment of Clostridium difficile-associated disease. Antimicrob Agents Chemother 2008;52:2403-2406.

  55. de Bruin MA, Riley LW. Does vancomycin prescribing intervention affect vancomycin-resistant enterococcus infection and colonization in hospitals? A systematic review. BMC Infect Dis 2007;10:24.




2020     |     www.medigraphic.com