CLOSTRIDIUM DIFFICILE ENTEROCOLITIS WHO IS AT RISK ?

Introduction and Objective In recent years, diarrhea caused by Clostridium difficile (CD) has become a hot topic. The use of antibiotics in the elderly is the most frequent named risk factor in literature, we searched for more data in order to improve preventive measures. Method We analyzed the incidence of Clostridium enterocolitis (CE) at the Department of long term ill in 2014. We tested the stool specimens for CD antigen and toxin in every patient with diarrhea. Results From 258 patients 58 had diarrhea. In 22 patients (8.5%) were antigen and toxin positive, in 24 patients (9.3%) was antigen positive and toxin negative. Mean age of antigen and toxin positive patients was 80.1 years, 16 of them were women (72%). Ciprofloxacin was the most used antibiotic on previous and our department too (as in year 2008). Only 48% patients with diarrhea used probiotics during hospitalization on previous departments, but up to 95% on our department. We analyzed several other factors (presence of bowel disease, count of previous episodes of CE, use of PPI, ATLAS and CSI score, diagnosis at admission, mobility, feeding by nasogastric tube, incontinence). Conclusion The most used antibiotics didn´t change over the years. The occurrence of CE with positivity of toxin seems to decrease from 10.2% in year 2008 to 8.5% in 2014 (not statistically significant, Fisher´s exact test p= 0.554). This slight decrease encourages us to stay vigilant. We present risk factors in our patients giving rise to the preventive measures of this dreaded nosocomial infection.