Srpski arhiv za celokupno lekarstvo 2013 Volume 141, Issue 7-8, Pages: 482-489
https://doi.org/10.2298/SARH1308482S
Full text ( 2024 KB)
Cited by
Epidemiological characteristics of nosocomial diarrhea caused by Clostridium difficile in a tertiary level hospital in Serbia
Šuljagić Vesna (Medicinski fakultet Vojnomedicinske akademije, Beograd)
Đorđević Dragan (Vojnomedicinska akademija, Beograd)
Lazić Srđan (Medicinski fakultet Vojnomedicinske akademije, Beograd)
Mijović Biljana (Univerzitet u Istočnom Sarajevu, Medicinski fakultet, Foča, Republika Srpska, Bosna i Hercegovina)
Introduction. Among the most important causes of diarrhea in modern hospitals
is Clostridium difficile (C. difficile). A wide spectrum of diseases caused
by this bacterium is now known as C. difficile associated disease (CDAD). The
development of CDAD is usually preceded by the administration of
antimicrobial therapy and fecal-oral infections with C. difficile. Over the
last years epidemiology of CDAD has significantly changed. Recently, a
hypervirulent BI/NAP1/027 strain, the cause of severe epidemics in North
America and Western Europe, has been identified. Objective. The aim of this
study was to identify risk factors for CDAD in patients operated on at the
Military Medical Academy (MMA). Methods. The study included all patients who
underwent surgery at the MMA during 2010. Nested case-control study design
was used. The subjects were divided into groups of operated patients with and
without CDAD. The patients were under prospective follow-up, while their data
were collected using a questionnaire during a routine epidemiological
control. Results. During 2010 the incidence rate of CDAD was 3.3 per 10,000
hospital days. Univariate regression analysis showed that the length of
administration of one or two antibiotics, as well as concurrent
administration of two antibiotics, were far more frequently observed in the
patients with than in the patients without CDAD. Independent risk factor for
the development of CDAD was the length of the administration of one
antibiotic. Conclusion Reduction in the incidence rate of CDAD can be
achieved by using reliable measures of prevention and control; the rational
use of antibiotics, early diagnosis and therapy of infected patients, contact
isolation of infected persons, proper disinfection, and continued education
of medical and non-medical personnel.
Keywords: Clostridium difficile associated disease (CDAD), risk factor, epidemiology, prevention and control