Infección por Clostridium difficile: descripción de las cepas NAP1/027 y noNAP1/027 en un centro de alta complejidad en Cali-Colombia, 2012-2015

Abstract

Introduction. Clostridium difficile is considered as one of the principal pathogens to cause nosocomial infections increasing morbidity and mortality. The strain NAP1/027 of Clostridium difficile has been associated with an increased toxin production as well as a severe outcome in disease burden. Objective. Describe the epidemiology of infections associated with Clostridium difficile and the characteristics related with the NAP1/027 strain. Materials and methods. Observational study based on the review of medical chart of patients with positive stool specimens for Clostridium difficile between 2012 and 2015 by the Xpert test. The severity of the disease was assessed with ATLAS score. Results. 42 cases of Clostridium difficile infections were included and 9 of them were positive for the NAP1/027 strain. The use of antibiotics prior to infection for more than 7 days was more frequent among cases who tested negative for NAP1/027. The duration of diarrhea lasted more than 5 days in half of the patients and there was no differences in the strain found (p>0.05). Cases which tested positive for strain NAP1/027 were characterized for manifesting foul and bloody stools. There were no significant differences in severity of infection between positive and negative cases of NAP1/027 strain. Conclusion. Clostridium difficile is the main causative agent of antibiotic associated diarrhea. In Colombia there is transmission of NAP1/027 strain without significant clinical differences which could be due to a limited number of patients. However, the incidence of NAP1/027 strain must raise an alert on medical staff and healthcare institutions due to its high severity and mortality.