Health care associated Clostridium difficile infections in University Hospital Trnava during last five years (2010 – 2014)

Abstract

Introduction: In Slovakia, mandatory surveillance of Clostridium difficile infection (CDI) have been established due to electronically national Epidemiological information systems (EPIS) long time ago, but compliance to surveillance are low. Objectives: The aim of this hospital-based study was to assess real prevalence and outcome of CDI in University Hospital Trnava, Slovakia during years 2010-2014. Methods: We analysed all patients with laboratory confirmed CDI (RIDAQUICK Clostridium difficile Toxin A/B immunochromatographic rapid assay, R-Biopharm) in University Hospital Trnava (618-bed; approx. 25 000 patients per year) from laboratory information system and medical records. Results: During five years period were identified 317 CDI with declining trend in recent years for 10 000 admission. Health care associated CDI (HA-CDI) accounted for 75,7% (240). The mean age of patients was 72,8 +/- 15 years (range 15-96) and 60,3% (191) were women. The most frequently antibiotics used before onset CDI were quinolones (25,9%) for the treatment of respiration or urinary tract infection. Overall recurrence of CDI was observed within 3 months after the first episode in 6,9% (22) of cases. Total hospital mortality rate was 13,9% (44) and hospital mortality associated with CDI only 1,9% (6). Conclusion: These results show high prevalence HA-CDI in our hospital and emphasizing the importance of implementing better infection control practice in order to prevent further spread. To date no data about specific ribotype of Clostridium difficile and about prevalence in long-term care facility are available in Slovakia.