Original scientific paper
Pilot surveillance of Clostridium difficile infections among patients with diarrhoea in medical facilities of Tbilisi, Georgia
David Tsereteli
; Department of Communicable Diseases, National Center for Disease Control and Public Health, Tbilisi, Georgia
Ketevan Sidamonidze
; R.G. Lugar Center for Public Health Research, National Center for Disease Control and Public Health, Tbilisi, Georgia
Marika Tsereteli
; Department of Infectious Diseases, Tbilisi State Medical University, Tbilisi, Georgia; High Technology Medical Center, University Clinic, Tbilisi, Georgia
Giorgi Chakhunashvili
; Department of Communicable Diseases, National Center for Disease Control and Public Health, Tbilisi, Georgia
Ekaterine Zhghenti
; R.G. Lugar Center for Public Health Research, National Center for Disease Control and Public Health, Tbilisi, Georgia
Lile Malania
; R.G. Lugar Center for Public Health Research, National Center for Disease Control and Public Health, Tbilisi, Georgia
Ghinwa Dumyati
; University of Rochester Medical Center, Rochester, New York, USA
David L. Morse
; Division of Foodborne, Waterborne and Environmental Diseases, the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, USA
Abstract
Background: Clostridium difficile infection (CDI) is the most frequent cause of healthcare-associated diarrhoea and is increasingly recognized in the community. The epidemiology of CDI in Georgia is unknown.
Methods: Pilot surveillance for CDI among patients with diarrhoea was conducted in four hospital ICUs, and three outpatient clinics in Tbilisi, Georgia. Demographic, clinical and treatment data of patients with CDI were collected from medical records. A CDI diagnosis was made if the stool sample was positive for C. difficile toxin A and/or B by nucleic acid amplification test or enzyme immunoassay, or by culture of a toxin-producing C. difficile.
Results: A total of 131 patients with new onset diarrhoeal illness were recruited. Of these, laboratory confirmed CDI was found in 24% (31/131): 32% (17/53) of adult and 20% (11/55) of paediatric ICU patients, 22% (2/9) adult and 7% (1/14) of paediatric outpatients. Presenting symptoms were fever (>380C) and diarrhoea with a median duration 7 days. Most CDI cases received antibiotics before diagnosis; 94% of adults and 91% of children diagnosed in the ICU (median: 12 days); the majority receiving simultaneously two or more antibiotics. In the outpatient settings, 100% of CDI case-patients received an antibiotic for a median duration of 7 days.
Conclusions: This pilot surveillance demonstrated that C. difficile is a common cause of diarrhoea in hospitalized and community patients in Georgia. It highlights the need to improve the knowledge of medical providers regarding the burden of CDI and to establish diagnostic testing at hospital laboratories.
Keywords
Clostridium difficile infection; community-associated; healthcare-associated; diarrhoea
Hrčak ID:
204598
URI
Publication date:
30.7.2018.
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