Abstract
BackgroundClostridium difficile, rarely found in hospitals, is a bacterium responsible for post-antibiotic diarrhea and Pseudomembranous Colitis (CPM). C. difficile selective pressure represents potential public health problem due to the production of toxins A and B serious pathologies effects/consequences. A transversal and analytic study was to assess the risk factors of C. difficile infection and to determine the prevalence of C. difficile in patients received in randomly selected five hospitals in Yaoundé, Cameroon.MethodsA total of 300 stool samples were collected from consented patients using a transversal and analytic study conducted from 10th July to 10th November 2018 in five hospitals in Cameroon. The detection or diagnostic kit was CerTest C. difficile Glutamate Dehydrogenase + Toxin A + Toxin B based on immuno-chromatographic assay. A univariate and multivariate analysis allowed us to highlight the associated factors.ResultsThe results showed a prevalence of C. difficile of 27.33% (82/300 stool patients’samples taken). Of these 27.33%, the production of Toxin A and Toxin B were 37.80 and 7.31% respectively. In univariate analysis, hospitalization was a significant (P = 0.01) risk factor favoring C. difficile infection. In multivariate analysis, corticosteroids and quinolones use/administration were significantly (adjusted Odd Ratio, aOR = 14.09, 95% CI: 1.62–122.54, P = 0.02 and aOR = 3.39, 95% CI: 1.00–11.34, P = 0.05 respectively) risk factor for this infection.ConclusionThe prevalence of C. difficile infections (CDI) remain high in these settings and may be related not only to permanent steroids and antibiotics. Promoting education to both medical staff and patients on the prevalence and public health impact of C. difficile can be core inimproving rationale prescription of steroids and antibiotics to patients and promote human health and exponential growth in Cameroon.
Highlights
Clostridium difficile, rarely found in hospitals, is a bacterium responsible for post-antibiotic diarrhea and Pseudomembranous Colitis (CPM)
The study aims at defining the risk factors of C. difficile infection (CDI), the prevalence and impact of treatment outcomes in order to contribute to the fight against C. difficile resistance emergence in Cameroon
The number of patients according to hospital site were 96 patients (32.0%) were University Hospital Center (CHUY), 74 patients (24.7%) on Central hospital (HCY), 53 patients (17.7%) on Military hospital (HM), 42 patients (14.0%) on HP and 35 patients (11.7%) on Efoulan hospital (HE) (Table 1)
Summary
Clostridium difficile, rarely found in hospitals, is a bacterium responsible for post-antibiotic diarrhea and Pseudomembranous Colitis (CPM). Clostridium difficile is the most frequent infectious cause of nosocomial diarrhea and a major financial burden for health-care systems [1,2,3]. It is responsible of about 25% of reported antibiotic-associated diarrhea cases and virtually all cases of pseudomembranous colitis (PMC) worldwide [4]. Little is documented on the risk factors and prevalence of C. difficile in hospitals and community health care settings in Cameroon. The study aims at defining the risk factors of CDI, the prevalence and impact of treatment outcomes in order to contribute to the fight against C. difficile resistance emergence in Cameroon
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