The undiagnosed cases of Clostridium difficile infection in a whole nation: where is the problem?
| Autor: | Antonio Sánchez-Porto, Emilio Bouza, Rafael Canton, Juan Cuadros-González, Fajardo Miguel, Pere Coll, Clotilde Fernández Gutiérrez del Álamo, María Teresa Pérez Pomata, Luis Martínez Martínez, Francisco Jesús Merino Fernández, Teresa Nebreda-Mayoral, Carlos Lorenzo, LAURA VILLA, Juan-Ignacio Alós, RAMIRO LÓPEZ-MEDRANO, Fernando Vazquez-Valdes |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Microbiology (medical) medicine.medical_specialty Pediatrics Adolescent underdiagnosis susceptibility Feces Young Adult Ribotyping Prevalence medicine Humans In patient Diagnostic Errors Young adult Child ribotyping Aged Clinical Laboratory Techniques Clostridioides difficile business.industry Incidence (epidemiology) Clostridium difficile General Medicine Middle Aged multicentre study Surgery Spanish population Metronidazole Infectious Diseases Spain Child Preschool Clostridium Infections incidence Vancomycin Female business medicine.drug |
| Zdroj: | Clinical Microbiology and Infection. 18:E204-E213 |
| ISSN: | 1198-743X |
| Popis: | Underdiagnosis of Clostridium difficile infection (CDI) because of lack of clinical suspicion or the use of non-sensitive diagnostic techniques is a known problem whose real magnitude has not yet been quantified. In order to estimate the extent of this underdiagnosis, we performed C. difficile cultures on all unformed stool specimens sent—irrespective of the type of request—to a series of laboratories in Spain on a single day. The specimens were cultured, and isolates were characterized at a central reference laboratory. A total of 807 specimens from 730 patients aged ≥2 years were selected from 118 laboratories covering 75.4% of the Spanish population. The estimated rate of hospital-acquired CDI was 2.4 episodes per 1000 admissions or 3.8 episodes per 10 000 patient-days. Only half of the episodes occurred in patients hospitalized for >2 days. Two of every three episodes went undiagnosed or were misdiagnosed, owing to non-sensitive diagnostic tests (19.0%) or lack of clinical suspicion and request (47.6%; mostly young people or non-hospitalized patients). The main ribotypes were 014/020 (20.5%), 001 (18.2%), and 126/078 (18.2%). No ribotype 027 strains were detected. Strains were fully susceptible to metronidazole and vancomycin. CDI was underdiagnosed in diarrhoeic stools in a high proportion of episodes, owing to the use of non-sensitive techniques or lack of clinical suspicion, particularly in people aged |
| Databáze: | OpenAIRE |
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