Abstract
Background: Clostridium difficile is known as a prevalent pathogen leading to infections ranging from mild diarrhea to severe disease and death. The aim of the present study was to evaluate the incidence of C. difficile from inpatients with nosocomial diarrhea hospitalized in different wards in the northwest region of Iran. Methods: In this cross-sectional study, 485 diarrheal stool samples were collected from 384 patients referred from different wards of Imam Reza, Sina and Pediatric hospitals, Tabriz and transferred to the laboratory from 25 March 2015 till 1 March 2018. Immuno-chromatographicassay for detection of toxins A and B of C. difficile was used for identification. Results: Clostridium difficile was isolated from 24 (4.7%) out of 485 samples. Fifteen patients(62.5%) were males and 9 were females (37.5%). Twelve positive patients were from the gastrointestinal ward (50%), 5 patients (20.8%) from surgery ward, 3 patients from infectious disease ward (12.5%), 3 patients from rheumatology ward (12.5%) and 1 patient (4.1%) were collected from neurology ward. 95.3% of diarrhea samples had no signs from toxin A and B. Conclusion: These results indicate most of infected patients were from the gastrointestinaland surgery wards which show a different pattern of infection compared to previous studies.The neurology department had the lowest rate of infection. C. difficile is a health threat afterantibiotic consumption and for health promotion, developing strategies for less antibioticconsumption and preventing these emerging infections is critical. The low rate of this infection shows improvement in knowledge and effect of stewardships in physicians.
Highlights
Clostridium difficile is an anaerobic gram-positive sporeforming rod that is part of normal flora in the human intestine in 3% of healthy individuals, 15%-20% of infants and in 10% to 30% chronically ill or hospitalized people
Due to the lack of knowledge on rate of this infection in the region and factors related to its establishment, in the present study, we aimed to investigate the presence and incidence of C. difficile in different wards as consequence of antibiotic-associated diarrhea by using immuno-chromatographic assay in the northwest of Iran
No significant differences were observed in the presence of toxin with sex, outpatient or hospitalization and hospital admission (Table 1). 95.8% of infected patients had a history of antibiotic consumption including cephalosporins, ciprofloxacin, and co-amoxiclav
Summary
Clostridium difficile is an anaerobic gram-positive sporeforming rod that is part of normal flora in the human intestine in 3% of healthy individuals, 15%-20% of infants and in 10% to 30% chronically ill or hospitalized people. Clostridium difficile is known as a prevalent pathogen leading to infections ranging from mild diarrhea to severe disease and death. Methods: In this cross-sectional study, 485 diarrheal stool samples were collected from 384 patients referred from different wards of Imam Reza, Sina and Pediatric hospitals, Tabriz and transferred to the laboratory from 25 March 2015 till 1 March 2018. Conclusion: These results indicate most of infected patients were from the gastrointestinal and surgery wards which show a different pattern of infection compared to previous studies. The low rate of this infection shows improvement in knowledge and effect of stewardships in physicians
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