Abstract
Aim. To assess etiologic factor of Clostridium genus associated infection and its influence on the disease clinical course. Materials and methods. 549 in-hospital patients participated in the study. We evaluated clinical and biochemical parameters of blood, stool frequency or stoma function intensity, feces volume per day and length of in-hospital stay. We performed stool sampling three times: during 48 hours after admission, in case of diarrhea and prior discharge. We evaluated glutamate-dehydrogenase (GDH) and Clostridium difficile toxins A and B by means of immunological assays. All samples underwent cultivation in anaerobic conditions. Results. Analysis of clostridial infection ethiologic factor has revealed 38 (17,9%) cases of clostridial diarrhea associated with another Clostridium species. We discovered Clostridium perfringens in 32 (84%) cases, Clostidium novyi in 5 (13%) cases and Clostidium hathewayi in 1 (3%) patient. Diarrhea severity, clinical and laboratory inflammation markers did not differ significantly depending on the isolated etiological agent of clostridial infection and its titer. Clostridial infection significantly increased in-hospital post-surgery length of stay by 4 days (p < 0,01). Conclusions. Symptoms C. difficile-associated infection could occur not only in case of persisting C. difficile but also in cases of other Clostridium species. Clinical manifestation of C. difficile-associated infection increase in-hospital stay.
Highlights
The экспериментальная и клиническая гастроэнтерология | выпуск 160 | No 12 2018 хирургическая гастроэнтерология | surgical gastroenterology statements were grouped into the following six broad themes: diagnosis; definitions of severity; treatment failure, recurrence and its consequences; infection prevention and control interventions; education and antimicrobial stewardship; and National CDI clinical guidance and policy. These statements were reviewed using questionnaires by 1047 clinicians involved in managing CDI, who indicated their level of agreement with each statement. \n\nFINDINGS\nLevels of agreement exceeded the 66% threshold for consensus for 27 out of 29 statements
У 38 (18%) из 212 больных клиническая картина была обусловлена другими представителями рода Clostridium (у 32 (84%) пациентов обнаружена Clostridium perfringens, у 5 (13%) больных–Clostidium novyi, у 1 (3%) пациента – Clostidium hathewayi)
У 5 (13%) пациентов с наличием колостомы был проанализирован объем потерь кишечного содержимого, при этом медиана этого показателя составила 750 (550; 1000) мл/сутки
Summary
549 in-hospital patients participated in the study. We evaluated clinical and biochemical parameters of blood, stool frequency or stoma function intensity, feces volume per day and length of in-hospital stay. We performed stool sampling three times: during 48 hours after admission, in case of diarrhea and prior discharge. We evaluated glutamate-dehydrogenase (GDH) and Clostridium difficile toxins A and B by means of immunological assays. All samples underwent cultivation in anaerobic conditions
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