Endoscopy 2022; 54(S 01): S133
DOI: 10.1055/s-0042-1744913
Abstracts | ESGE Days 2022
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CLINICAL PROFILE, RISK FACTORS AND TREATMENT OUTCOMES OF CLOSTRIDIOIDES DIFFICILE ASSOCIATED DIARRHOEA: A HOSPITAL BASED OBSERVATIONAL STUDY FROM WESTERN INDIA

H. Gadhikar
1   Deenanath Mangeshkar Hospital and Research Institute, Shivanand Desai Centre for Digestive Disorders, Pune, India
,
H. Raina
1   Deenanath Mangeshkar Hospital and Research Institute, Shivanand Desai Centre for Digestive Disorders, Pune, India
,
S. Patwardhan
2   Deenanath Mangeshkar Hospital, Microbiology, Pune, India
,
P. Prayag
3   Deenanath Mangeshkar Hospital, Infectious Disease, Pune, India
,
A. Gandhi
1   Deenanath Mangeshkar Hospital and Research Institute, Shivanand Desai Centre for Digestive Disorders, Pune, India
,
S. Bhagwat
1   Deenanath Mangeshkar Hospital and Research Institute, Shivanand Desai Centre for Digestive Disorders, Pune, India
,
T. Nikumbh
1   Deenanath Mangeshkar Hospital and Research Institute, Shivanand Desai Centre for Digestive Disorders, Pune, India
,
A. Bapaye
1   Deenanath Mangeshkar Hospital and Research Institute, Shivanand Desai Centre for Digestive Disorders, Pune, India
› Author Affiliations
 

Aims To study the increasing incidence of Clostridioides difficile associated Diarrhoea (CDAD) in a tertiary hospital in central India.

Methods All adult patients of Diarrhoea, who presented to our hospital for last seven months and whose samples were sent for stool testing for Clostridioides difficile were included in the study. All demographic and clinical profile, possible risk factors and treatment response were evaluated. CDAD was confirmed with detection of Toxin A or B or both using ELISA.

Results N=267. Prevalence of CDAD-33.7%; toxin positivity -26.21% (70/267); Glutamate dehydrogenase (GDH)antigen positivity – 7.49% (20/267). Nosocomial infection – 58.80% (53/90); Community acquired infection – 35.55% (32/90); Health care associated infection – 5.57% (5/90). Recent antibiotic use, Proton Pump Inhibitors (PPIs) use, steroid use>2 weeks, Intensive Care Unit (ICU) stay and chemotherapy were independent risk factors. Response rates to vancomycin and metronidazole-85.54% (77/90). Non or partial responders were treated with teicoplanin and probiotics with response rate of 61.53%. Faecal Microbiota Transplant (FMT) – 4 patients, clinical success – 100%. Recurrence rate of CDI – 6.66% (6/90). 30-day mortality rate – 3.33%.

Conclusions Clostridioides difficile associated Diarrhoea (CDAD) is one of the important causes of acute Diarrhoea in the hospital and community set up. PPIs, antibiotics, chemotherapy, steroids and ICU stay are the main risk factors for CDAD. Vancomycin and metronidazole are drugs of choice as first line treatment options for CDAD. Teicoplanin or FMT can be used in unresponsive or recurrent cases.



Publication History

Article published online:
14 April 2022

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