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Revista Médica del Uruguay
versão impressa ISSN 0303-3295versão On-line ISSN 1688-0390
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MENENDEZ, Mercedes; BATISTA, Noelia; BALSAMO, Andrés e SEIJA, Verónica. Predictores de riesgo para desarrollo de infección por Clostridium difficile. Rev. Méd. Urug. [online]. 2016, vol.32, n.3, pp.159-165. ISSN 0303-3295.
Abstract Clostridium difficile (CD) is the agent responsible for most nosocomial diarrhea episodes. The study aims to identify risk factors for the development of CD infection (CDI) in patients with nosocomial diarrhea at the “Dr. Manuel Quintela” University Hospital. To that end, and observational, analytical study of cases and non-paired controls was conducted. All patients older than 18 years old who developed diarrhea after 72 hours in hospital and who were requested a CD search from April to December, 2013 were included in the study. Twenty seven patients (18.6%) complied with the case definition and 105 (72.4%) complied with the control definition and 13 (9.0%) were excluded, as they only evidenced a glutamate dehydrogenase (GLDH) positive test. As to the clinical presentation, the significant association of CDI with fever is pointed out. The single variable analysis revealed that having received antibiotics for over 30 days and the previous use of clindamycin were significantly associated to CDI. In the multivariable analysis, the mere use of clindamycin (p=0.004 OR 5.881 IC95% 1.743-19.841) persisted as an independent risk factor. The latter proves that, upon an endemic situation, the implementation of a policy for the rational use of clindamycin is one of the measure needed to reduce the frequency of CDI.
Palavras-chave : CLOSTRIDIUM DIFFICILE; RISK FACTORS.