IS CLOSTRIDIUM DIFFICILE ENDEMIC IN CHRONIC-CARE FACILITIES?

作者：BradleyS. Bender, Barbara E. Laughon, Charlotte Ann Gaydos, MichaelS. Forman, Richard G. Bennett, W. B. Greenough, Stephen D. Sears, JohnG. Bartlett · 发表于：The Lancet · 年份：1986 · DOI：10.1016/s0140-6736(86)92559-6 · 被引用次数：190 · 研究领域：Clostridium difficile and Clostridium perfringens research、Botulinum Toxin and Related Neurological Disorders、Bacterial Identification and Susceptibility Testing

An apparent outbreak of Clostridium difficile diarrhoea on the chronic hospital ward of a long-term care facility prompted an investigation lasting seven months. Approximately a third of patients had stools that were positive for C difficile by either toxin or culture. Attempts to eradicate the infection by simultaneously treating all toxin-positive patients with metronidazole, limiting antibiotic use, and implementing enteric isolation were unsuccessful. New cases were both nosocomially acquired and imported into the facility. Of the C difficile toxin-positive patients, 34% had diarrhoea and 19/49 (38%) died during the study period. C difficile is not routinely sought by most clinical microbiology laboratories and may therefore be endemic in many long-term care facilities for the elderly.