Original article / research
Prevalence and Outcome of Clostridioides difficile Infection in a Tertiary Care Hospital in Kerala, India
Dr. Aneeta Mary Jacob,
Assistant Professor, Department of Microbiology, Pushpagiri Institute of Medical Sciences and Research Centre,
Tiruvalla-689001, Kerala, India.
Introduction: Increasing incidence of Clostridioides difficile Infections (CDI) has been associated with antibiotic usage. The most commonly used test for its diagnosis is Glutamate Dehydrogenase (GDH) enzyme along with toxin assay. Implementation of strict infection control practices are required to curb rising prevalence and outbreaks.
Aim: The aim of this study was to find the prevalence of CDI in the hospital and to analyse the risk factors leading to its development.
Materials and Methods: Stool samples were screened for the presence of GDH enzyme and toxins A and B. Samples positive in both tests were considered as CDI cases. For risk factor analysis, 50 cases were randomly selected (25 toxin positive cases vs 25 GDH negative cases).
Results: A total of 493 stool samples were analysed over two years of which 18.5% were toxin A and B positive. The prevalence of CDI decreased from 0.1% to 0.06% in the second year. The GDH values of all toxin positive cases were much higher than that of the cut off of 0.1 IU/mL, while among the non-toxigenic strains, high GDH value was noted in 49.7%. The significant risk factors for CDI in the present study were old age, diabetes, hypertension, renal diseases and cerebrovascular accidents.
Conclusion: The most common test used for the diagnosis of CDI is GDH enzyme along with toxin assay. CDI is significantly related to risk factors.
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