Multicenter study on Clostridioides difficile infections in Mexico: exploring the landscape.

Autor:	De-la-Rosa-Martinez D; Instituto Nacional de Cancerología, Mexico City, Mexico.; F. I. Proctor Foundation, University of California San Francisco, San Francisco, USA., Vilar-Compte D; Instituto Nacional de Cancerología, Mexico City, Mexico., Martínez-Rivera N; Instituto Nacional de Cancerología, Mexico City, Mexico., Ochoa-Hein E; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico., Morfin-Otero R; Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico., Rangel-Ramírez ME; Hospital General 'Dr. Agustín O'Horán', Mérida, Mexico., Garciadiego-Fossas P; Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico., Mosqueda-Gómez JL; Hospital Regional de Alta Especialidad del Bajío, Servicios de Salud del Instituto Mexicano de Seguro Social para el Bienestar (IMSS-BIENESTAR), Guanajuato, Mexico., Rodríguez Zulueta AP; Hospital General 'Dr. Manuel Gea González', Mexico City, Mexico., Medina-Piñón I; Christus Muguerza Hospital del Parque, Chihuahua, Mexico., Franco-Cendejas R; Instituto Nacional de Rehabilitación, Mexico City, Mexico., Alfaro-Rivera CG; Hospital Ángeles del Carmen, Guadalajara, Mexico., Rivera-Martínez NE; Hospital Regional de Alta Especialidad de Oaxaca, Servicios de Salud del Instituto Mexicano de Seguro Social para el Bienestar (IMSS-BIENESTAR), Oaxaca, Mexico., Mendoza-Barragán J; Hospital Ángeles Chihuahua, Chihuahua, Mexico., López-Romo AE; Christus Muguerza Hospital Alta Especialidad, Monterrey, Mexico., Manríquez-Reyes M; Hospital Español de Veracruz, Veracruz, Mexico., Martínez-Oliva DH; Hospital Regional de Alta Especialidad de la Península de Yucatán, Mérida, Mexico., Flores-Treviño S; Hospital Universitario 'Dr. José Eleuterio González', Monterrey, Mexico., Azamar-Marquez JM; Hospital Universitario 'Dr. José Eleuterio González', Monterrey, Mexico., Valverde-Ramos LN; Hospital General 'Dr. Manuel Gea González', Mexico City, Mexico., Nieto-Saucedo JR; Hospital Regional de Alta Especialidad del Bajío, Servicios de Salud del Instituto Mexicano de Seguro Social para el Bienestar (IMSS-BIENESTAR), Guanajuato, Mexico., Aguirre-Díaz SA; Hospital Civil de Guadalajara 'Fray Antonio Alcalde', Guadalajara, Mexico., Camacho-Ortiz A; Hospital Universitario 'Dr. José Eleuterio González', Monterrey, Mexico.
Jazyk:	angličtina
Zdroj:	Infection control and hospital epidemiology [Infect Control Hosp Epidemiol] 2024 Oct 21, pp. 1-8. Date of Electronic Publication: 2024 Oct 21.
DOI:	10.1017/ice.2024.153
Abstrakt:	Objective: This study aims to outline Clostridioides difficile infection (CDI) trends and outcomes in Mexican healthcare facilities during the COVID-19 pandemic. Design: Observational study of case series. Setting: Sixteen public hospitals and private academic healthcare institutions across eight states in Mexico from January 2016 to December 2022. Patients: CDI patients. Methods: Demographic, clinical, and laboratory data of CDI patients were obtained from clinical records. Cases were classified as community or healthcare-associated infections, with incidence rates calculated as cases per 10,000 patient days. Risk factors for 30-day all-cause mortality were analyzed by multivariate logistic regression. Results: We identified 2,356 CDI cases: 2,118 (90%) were healthcare-associated, and 232 (10%) were community-associated. Common comorbidities included hypertension, diabetes, and cancer. Previous high use of proton-pump inhibitors, steroids, and antibiotics was observed. Recurrent infection occurred in 112 (5%) patients, and 30-day mortality in 371 (16%). Risk factors associated with death were a high Charlson score, prior use of steroids, concomitant use of antibiotics, leukopenia, leukocytosis, elevated serum creatine, hypoalbuminemia, septic shock or abdominal sepsis, and SARS-CoV-2 coinfection. The healthcare-associated CDI incidence remained stable at 4.78 cases per 10,000 patient days during the pre-and pandemic periods. However, the incidence was higher in public hospitals. Conclusions: Our study underscores the need for routine epidemiology surveillance and standardized CDI classification protocols in Mexican institutions. Though CDI rates in our country align with those in some European countries, disparities between public and private healthcare sectors emphasize the importance of targeted interventions.
Databáze:	MEDLINE
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