Clostridium difficile – still a problem among the XXI century in case of geriatic patient

Agnieszka Ulatowska; Katarzyna Plagens-Rotman; Małgorzata Piskorz-Szymendera; Elżbieta Włodarczyk; Natalia Smolarek; Izabela Miechowicz; Andrzej Jóźwiak; Grażyna Bączyk

doi:10.20883/jms.2017.257

Authors

Agnieszka Ulatowska Department of Nursing Practice, Faculty of Health Sciences, Poznan University of Medical Sciences, Poland
Katarzyna Plagens-Rotman Department of Mother and Children Health, Poznan University of Medical Sciences, Poland
Małgorzata Piskorz-Szymendera Department of Organization and Management in Healthcare, Faculty of Health Sciences, Poznan University of Medical Sciences, Poland
Elżbieta Włodarczyk Department of Organization and Management in Healthcare, Faculty of Health Sciences, Poznan University of Medical Sciences, Poland
Natalia Smolarek Department of Mother and Children Health, Poznan University of Medical Sciences, Poland
Izabela Miechowicz Department of Computer Science and Statistics, Faculty of Medicine II, Poznan University of Medical Sciences, Poland
Andrzej Jóźwiak Department of Geriatrics, The Regional Hospital for Mental Diseases "Dziekanka" in Gniezno, Poland
Grażyna Bączyk Department of Nursing Practice, Faculty of Health Sciences, Poznan University of Medical Sciences, Poland

DOI:

https://doi.org/10.20883/jms.2017.257

Keywords:

infection, Clostridium difficile, elderly person

Abstract

Introduction. The disease caused by Clostridium difficile (CzcD - Clostridium difficile -associated disease) - was defined by the Centres for Disease Control and Prevention in Atlanta in 2007 in order to standardize monitoring conditions of diarrhea caused by the bacterium Clostridium difficile [1]. It is a gram-positive bacterium forming part of intestinal flora that causes among others pseudomembranous colitis in elderly patients. Occur to the destruction of anaerobic flora through the application of antibiotics and mass colonization of the bacterium Clostridium difficile in the large intestine. The diarrhea may resolve spontaneously but in older people often causes a severe form of life-threatening condition. [2–3]. The determinants which are the criteria for diagnosis of Clostridium difficile is a toxin A and/or B in the stool or demonstration of the presence of Clostridium difficile strain.
Aim. The aim of the study was evaluation the bacterium Clostridium difficile infection in geriatric patients among hospitalized in Department of Geriatrics at Regional Hospital for Mental Diseases "Dziekanka" in Gniezno in the years 2015 - 2016 and compare the information of infections in the years 2012 - 2014 in the same department and the same hospital.
Material and Methods. Studied material consisted of data from the medical records based on 1 342 patients from Regional Hospital for Nervous and Mental Patients “Dziekanka” in Gniezno. It was analyzed the following parameters: gender, age of the patient, duration of hospitalization, antibiotics before diarrhea, basic diseases and coexisting diseases.
Results. The study included in total 1 342 patients. Clostridium difficile diagnosed in 4 people which is 0.3% of all diagnosed patients. Among the coexisting diseases was diagnosed heart failure (50%), anemia (75%) and renal failure (50%). First-line treatment was vancomycin and metronidazole.
Conclusions. Must be taken prevention of infection with Clostridium difficile through early detection and implementation of medical procedures, medicines and sanitary-epidemiological procedures.

Downloads

Download data is not yet available.

References

Hryniewicz W, Martirosian G, Ozorowski T. Zakażenia C. difficile – diagnostyka, terapia, profilaktyka. Narodowy Program Ochrony Antybiotyków, Moduł I – Monitorowanie zakażeń szpitalnych oraz nawracających zakażeń bakteryjnych dla celów epidemiologicznych, terapeutycznych i profilaktycznych na lata 2009–2013.

Musz-Kawecka M, Hawro M, Golec K. Choroba związana z Clostridium difficile u pacjentów hospitalizowanych w Centrum Medycznym w Łancucie – badania retrospektywne. Przegląd Medyczny Uniwersytetu Rzeszowskiego i Narodowego Instytutu Leków w Warszawie. 2013;3:342–355.

Ulatowska A, Bączyk G, Plagens-Rotman K, Miechowicz I, Pawlaczy M, Jóźwiak A. Analiza częstości występowania Clostridium difficile wśród pacjentów geriatrycznych. Geriatria. 2015;2:96–101.

Carter Y, Barry D. Walka z C. difficile za pomocą mycia środowiska szpitalnego. Nursing Times. 2011;107:22–36.

Muszalik M, Kędziora – Kornatowska K, Ciosek A. Problemy związane z adaptacją oraz oczekiwania hospitalizowanych osób w starszym wieku. Gerontologia Polska. 2008;16:41–46.

Gerding DN, Johnson S, Peterson LR, Mulligan ME, Silva J Jr. Clostridium difficile – associated diarhea and colitis. Infect Control Hosp Epidemiol. 1995;16:459–477.

Mehlich A, Górska S, Gamian A, Myc A. Wybrane aspekty zakażeń Clostridium difficile. Postępy Hig Med Dosw. 2015;69;598–611.

Pietrzak AM. Zakażenie Clostridium difficile o ciężkim przebiegu. Postępy Nauk Medycznych. 2014;1:41–45.

Piekarska A. Standardy postepowania w objawowym zakażeniu Clostridium difficile (CDI). Przegląd Epidemiologiczny. 2015;69:401–412.

Grzesiowski P. Krytyczne procedury. Menadżer zdrowia. 2008;4:44–48.

Lai KK, Melvis ZS, et al. Clostridium difficile – associated diarrhea: epidemiology,risc factors, and infection control. Infect Control Hosp Epidemiol. 1997;18:628–632.

Ho M, Yang D, Wyle FA, et al. Increased incidence of Clostridium difficile – associated diarrhea following decreased restriction of antibiotic use. Clin Infect Dis. 1996;1:S102–S106.

Bobo LD, Dubberke ER. Recognition and prevention of hospital-associated enteric infections in the intensive care unit. Crit Care Med. 2010;38(8).

Brown KA, Khanafer N, Daneman N, Fisman DN. Meta – analysis of antibiotics and the risk of community – associated Clostridium difficile infection. Antimicrob Agents Chemother. 2013;57:2326–2332.

Cohen SH, Gerding DN, Johnson S, Kelly CP, et al. Clinical Practice Guidelines for Clostridium diff. infection in adults: 2010 update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA). Infection Control and Hospital Epidemiology. 2010;5:431–455.

Welfare MR, Lalayiannis LC, Martin KE, et al. Co-morbidities as predictors of mortality in Clostridium difficile infection and derivation of the ARC predictive score. J of Hospitals Infection. 2011;4:359–363.

Rozporządzenie Ministra Zdrowia z dnia 26 czerwca 2012 r. w sprawie szczegółowych wymagań, jakim powinny odpowiadać pomieszczenia i urządzenia podmiotu wykonującego działalność leczniczą.

European C. difficele – Infection Control Group and the European Centre for Disease Prevention and Control (ECDC): Infection control measures to limit the spread od Clostridium difficile. Clin Microbiol Infect. 2008;14:2–20.