Prevalence and characteristics of bacteria and host factors in an outbreak situation of antibiotic-associated diarrhoea
| Autor: | Susanne Thomalla, Frank Ackermann, Arne C. Rodloff, Grit Ackermann, Reiner Schaumann, Bernhard R. Ruf |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Diarrhea
Microbiology (medical) Staphylococcus aureus Clostridium perfringens Bacterial Toxins medicine.disease_cause Staphylococcal infections Microbiology Disease Outbreaks Enterotoxins Feces chemistry.chemical_compound Prevalence medicine Humans Cross Infection Clostridioides difficile business.industry General Medicine Staphylococcal Infections Clostridium difficile medicine.disease Anti-Bacterial Agents Metronidazole chemistry Population Surveillance Linezolid Clostridium Infections Vancomycin medicine.symptom business medicine.drug |
| Zdroj: | Journal of Medical Microbiology. 54:149-153 |
| ISSN: | 1473-5644 0022-2615 |
| DOI: | 10.1099/jmm.0.45812-0 |
| Popis: | Antibiotic-associated diarrhoea (AAD) represents a clinical entity leading to prolonged hospital stays and diagnostic and therapeutic procedures, and results in additional costs. The aim of the present study was to assess the prevalence and characteristics of different bacteria in stools of patients with AAD. The reliability of diagnostic procedures under routine conditions was evaluated. Host factors were also analysed. From June 2002 to April 2003 89 cases of diarrhoea were reported at a hospital unit for internal medicine. Clostridium difficile and Clostridium perfringens toxin enzyme-immunoassays (EIAs), and culture for C. difficile, C. perfringens and Staphylococcus aureus were performed on stool samples from all patients. Toxin production was determined in isolated S. aureus strains. In vitro susceptibility of S. aureus for oxacillin and of C. difficile for vancomycin, metronidazole, linezolid, fusidic acid and tetracycline was tested. Host factors, such as age, comorbidities, antibiotic exposure and contact with other patients, were evaluated. Twenty-six stools were positive for C. difficile toxins by an EIA technique, while C. difficile was cultured from 39. C. difficile was isolated from 21 stools that were EIA negative. Additionally, from 28 stools S. aureus and/or C. perfringens could be isolated. Nine samples contained only S. aureus and/or C. perfringens. Thirty-one stools were negative in all tests. All C. difficile isolates were susceptible to vancomycin and metronidazole. Age >60 years, and diseases of the vascular system, the heart, the kidneys and the lungs were identified as risk factors for acquiring C. difficile in this setting (P values < 0.05). Stool culture for C. difficile was shown to be more sensitive than toxin EIA in this study. Risk factors for the acquisition of C. difficile in outbreak situations seem to differ from risk factors in the normal hospital setting. The role of toxin-producing S. aureus in cases of AAD needs further investigation. |
| Databáze: | OpenAIRE |
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