96021 20201029165924.0 doi 10.17235/reed.2018.5288/2017 sideral 112466 ART-2019-112466 eng (orcid)0000-0001-7559-1763 Andrés Lasheras, Sara Incidence and characterization of Clostridium difficile in a secondary care hospital in Spain 2019 Access copy available to the general public Unrestricted INTRODUCTION: Clostridium difficile (C. difficile) is a major nosocomial infectious agent in hospitals. Previous studies have addressed the high proportion of infection episodes that are overlooked in health care facilities. OBJECTIVE: the main aim of this study was to characterize C. difficile clinical cases that occurred in a secondary care hospital during a five-month period. MATERIAL AND METHODS: for this purpose, a total of 137 stool samples from the same number of patients with diarrhea were analyzed for the presence of C. difficile by culture techniques. An enzyme immunoassay (EIA) test for the detection of C. difficile and its toxins was also used in 50 cases (36.5%) for diagnostic purposes. RESULTS: a total of 14 (10.2%) C. difficile isolates were obtained, of which nine (64.3%) were toxigenic. A mean incidence of 3.2 episodes of C. difficile infections (CDI) per 10, 000 patients-days was estimated for the study period. Around 56% of the CDI cases were determined as hospital-acquired, whereas 44% originated in the community. Among these, only two episodes (22.2%) were detected in the hospital by the EIA test, which indicated that the hospital CDI detection protocol needed to be revised. One unusual C. difficile isolate was negative for all toxin genes examined and also for the non-toxigenic strain assay, which highlights the need to perform genome sequencing to study its pathogenicity locus insertion site organization. A stable metronidazole-resistant C. difficile strain and three strains showing multidrug resistance were detected in this study, suggesting that C. difficile antimicrobial susceptibility surveillance programs should be established in this health-care facility. info:eu-repo/semantics/openAccess by http://creativecommons.org/licenses/by/3.0/es/ 1.591 2019 GASTROENTEROLOGY & HEPATOLOGY 81 / 88 = 0.92 2019 Q4 T3 0.383 2019 Medicine (miscellaneous) 2019 Q3 Gastroenterology 2019 Q3 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion (orcid)0000-0001-6016-4726 Martín Burriel, Inma Universidad de Zaragoza Aspiroz, Carmen (orcid)0000-0001-5442-7702 Mainar Jaime, Raul Carlos Universidad de Zaragoza Robres, Pilar (orcid)0000-0002-4213-2904 Sevilla, Eloísa Universidad de Zaragoza Kuijper, Ed Chirino Trejo, Manuel (orcid)0000-0002-2746-3932 Bolea, Rosa Universidad de Zaragoza 1001 420 Universidad de Zaragoza Dpto. Anatom.,Embri.Genét.Ani. Área Genética 1009 773 Universidad de Zaragoza Dpto. Patología Animal Área Sanidad Animal 111, 5 (2019), 338-344 Rev. esp. enferm. dig. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 1130-0108 615969 http://zaguan.unizar.es/record/96021/files/texto_completo.pdf Versión publicada 24782 http://zaguan.unizar.es/record/96021/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:96021 articulos driver 2020-10-29-14:06:21 ARTICLE