Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/37438

Type
Article
Copyright
Open access
Embargo date
2020-11-28
Collections
Share

Statistics
Metadata
Show full item record

AN OUTBREAK CASE OF CLOSTRIDIUM DIFFICILE-ASSOCIATED DIARRHEA AMONG ELDERLY INPATIENTS OF AN INTENSIVE CARE UNIT OF A TERTIARY HOSPITAL IN RIO DE JANEIRO, BRAZIL
Balassiano, Ilana Teruszkin et al. | Date Issued: 2010
Author
Balassiano, Ilana Teruszkin
Santos-Filho, Joaquim dos
Oliveira, Márcia Pinto Barros de
Ramos, Maria Catarina
Japiassu, André M.
Reis, Alessandro Mendonça dos
Brazier, Jon S.
Ferreira, Eliane de Oliveira
Domingues, Regina Maria Cavalcanti Pilotto
Affilliation
Universidade Federal do Rio de Janeiro. Centro de Ciências da Saúde. Instituto de Microbiologia Professor Paulo de Góes. Laboratório de Biologia de Anaeróbios. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.
Universidade Federal do Rio de Janeiro. Centro de Ciências da Saúde. Instituto de Microbiologia Professor Paulo de Góes. Laboratório de Biologia de Anaeróbios. Rio de Janeiro, RJ, Brasil.
INFECTO Consultoria. Rio de Janeiro, RJ, Brasil.
Serviço de Controle de Infecção Hospitalar de hospital terciário privado. Rio de Janeiro, RJ, Brasil.
Unidade de Terapia Intensiva de hospital terciário privado. Rio de Janeiro, RJ, Brasil.
Laboratório de Análises Clínicas de hospital terciário privado. Rio de Janeiro, RJ, Brasil.
University Hospital of Wales. Anaerobe Reference Unit. Cardiff, UK.
Universidade Federal do Rio de Janeiro, Xerém. Instituto de Microbiologia Professor Paulo de Góes. Duque de Caxias, RJ, Brasil.
Universidade Federal do Rio de Janeiro. Centro de Ciências da Saúde. Instituto de Microbiologia Professor Paulo de Góes. Laboratório de Biologia de Anaeróbios. Rio de Janeiro, RJ, Brasil.
Abstract
The aim of this study was to investigate Clostridium difficile-associated diarrhea (CDAD) in an intensive care unit (ICU) of a tertiary hospital in Rio de Janeiro, Brazil, and to characterize epidemiologically C. difficile strains obtained from an outbreak of CDAD. Within almost a 4-year surveillance period, CDAD incidence was determined for the first time in Brazil, and a 3-fold increase was observed in the average rate of CDAD, featuring an outbreak. About 80% of the patients were over 65 years. The main antibiotic that could be probably associated to CDAD was piperacillin/tazobactam. Four toxigenic strains were isolated, 3 from stools and 1 from environmental samples. They were all resistant to clindamycin and fluoroquinolones. Fingerprinting analysis revealed their distribution between 2 different polymerase chain reaction ribotypes, with one of them being exclusively found in Brazil. It was possible to detect cross-infection and environmental contamination in the ICU. Our results highlight the importance of a continuous CDAD surveillance in the hospitals, especially when a risk group is exposed.
Keywords
Clostridium difficile
Clostridium difficile-associated diarrhea
Intensive care unit
Elderly inpatients
 
Publisher
Elsevier
Citation
BALASSIANO, Ilana Teruszkin et al. An outbreak case of Clostridium difficile-associated diarrhea among elderly inpatients of an intensive care unit of a tertiary hospital in Rio de Janeiro, Brazil. Diagnostic Microbiology and Infectious Disease, v. 68, p. 449-455, 2010.
DOI
10.1016/j.diagmicrobio.2010.07.017
ISSN
0732-8893
Notes
André M. Japiassu. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento.