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P032: Clostridium difficile infection in Tenerife Canary Island, Spain
Antimicrobial Resistance and Infection Control volume 2, Article number: P32 (2013)
Clostridium difficile infections(CDI) epidemiology has changed:elevation in rate and severity of infection and increase in disease among outpatients
Aim of study was to evaluate the epidemiology of CDI in North Tenerife Area.
This is an epidemiological study performed in the Hospital Universitario de Canarias a tertiary care institution during 2011-2012.Studied population was outpatients or inpatients attended in this hospital with CDI suspected.Diagnostic procedures were based in GDH and later Toxin A/B detection as CDI confirmation in stool samples by EIA.Medical charts of patient were reviewed to collect: demographic variables, underlying diseases (diabetes(D), renal disease(RD),liver disease(LD),respiratory disease(ReD),cardiopathy(C),neoplasia(N)),> 3 co-morbidities,inflammatory boweldisease(IBD),solidorgan transplant(OST), immunocompromised states(IC),treatment previous,treatment of CDI,developed to Pseudo-membranous colitis(PMC),mortality due to CDI.The episodes were classificated as nosocomial, healthcare associated (HCA),community, indeterminate, and recurrence.
In 2011/2012 a total 18/45 episodes (17/41 patients) were diagnosticated. 50/62% were man and 7/22 (39/49%),<65 years.HCA and nosocomial CDI incidence were:0,7/1,7 case/104 patient–day.The services distribution was:Internal Medicine 6/12(33/27%), Nephrology 6/4(33/9%), Hematology 2/5(11/11%).Episodes:Community 4/7(22/15%), Nosocomial 14/27(78/60%), HCA 0/6(0/13%), Indeterminate 0/1(0/2%) and recurrences 0/4 (0/9%).In Nosocomial the time average between admission and CDI diagnostic was 10,6+ 9,1/24+ 29 d.Underlying diseases:C 10/9(55/20%),RD 5/10(27,7/22%),LD 2/4(11/9%), ReD 2/2(11/4%), N2/10(11/22%).> 3 co-morbidities 3/3(17/7%). IBD 1/1(6/2%), OST 7/3(39/6,6%),IC 10/20(55/44%),previous treatment:Omeprazol 6/10(33/22%), Ranitidine 3/1(17/2%),Aciclovir 1/2(5,6/4,4%),Carbapenems 6/21(33/47%),Fluorquinolones 5/13(28/29%),Cephalosporins (3-4ª) 4/11 (22/24%),Vancomycin(VA) 3/6(17/13%), Amoxicillin-clavunate 2/7(11/16%).CDI Treatment:Metronidazole 18/39(100/87%), VA 3/9 (17/20%), developed PMC 2/5(11/11%), death for CDI 1/0.
In our hospital there has been an increase in nosocomial CDI adquisition overtime and a high percentage in young patients.At 2012 OST patients declined and HCA episodes were increased thus we observed that CDI is not confined to hospitals.
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Hernández, M., Ramos, M. & Lecuona, M. P032: Clostridium difficile infection in Tenerife Canary Island, Spain. Antimicrob Resist Infect Control 2, P32 (2013) doi:10.1186/2047-2994-2-S1-P32
- Liver Disease
- Inflammatory Boweldisease
- Renal Disease