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Am. J. Trop. Med. Hyg., 77(5), 2007, pp. 802-805
Copyright © 2007 by The American Society of Tropical Medicine and Hygiene

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Epidemiology of Clostridium difficile–Associated Diarrhea in a Peruvian Tertiary Care Hospital

Coralith Garcia*, Frine Samalvides, Margot Vidal, Eduardo Gotuzzo, AND Herbert L. Dupont
Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Perú; Baylor College of Medicine, Houston, Texas; Hospital Nacional Cayetano Heredia, Lima, Perú; Center for Infectious Diseases, The University of Texas Health Science Center at Houston, Houston, Texas; St. Luke’s Episcopal Hospital, Houston, Texas

The prevalence, incidence, and epidemiologic factors of Clostridium difficile–associated diarrhea (CDAD) in a Peruvian hospital were studied. We conducted a cross-sectional study in patients > 14 years of age from medical/surgical wards of the Cayetano Heredia National Hospital (Lima, Peru) from September 2005 to May 2006. CDAD was defined in a case of nosocomial diarrhea when C. difficile toxin A and/or toxin B was detected by enzyme immune assay (EIA) in stools. A total of 4,264 patients were admitted, with 156 (3.7%) developing nosocomial diarrhea. Fifty-five of 156 (35.2%) cases of nosocomial diarrhea were diagnosed as CDAD. The overall incidence per 1,000 admissions was 12.9. Multivariate analysis showed that use of diapers (OR, 3.54; 95% CI, 1.71–7.34; P = 0.001) and presence of another patient with CDAD housed in the same room (OR, 2.97; 95% CI, 1.14–7.76; P = 0.026) were significantly associated with CDAD. Hospital transmission of C. difficile commonly occurred, supporting infection-appropriate measures directed toward the reduction of CDAD in low-resource settings.

Received February 1, 2007. Accepted for publication May 9, 2007.

Financial support: C. Garcia was supported by the Baylor-Cayetano Heredia Training Program in Global Infectious Diseases, Fogarty International Center, National Institutes of Health, Grant D43TW006569. The study was supported in part by the Center for Infectious Diseases, University of Texas–Houston School of Public Health and by the Public Health Service (Grant DK 56338), which funded the Texas Gulf Coast Digestive Diseases Center.

Disclosure: The authors state that there are no conflicts with the study.

* Address correspondence to Coralith Garcia, Av. Honorio Delgado 430, San Martin de Porres, Lima 31, Peru. E-mail: 03345{at}upch.edu.pe

Authors’ addresses: Coralith Garcia, Frine Samalvides, Margot Vidal, and Eduardo Gotuzzo, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayerano Heredia, Av. Honorio Delgado 430, San Martin de Porres, Lima 31, Peru, Telephone: 51-1-482-3910, Fax: 51-1-4823404, E-mail: 03345{at}upch.edu.pe. Herbert DuPont, St. Luke’s Episcopal Hospital, 6720 Bertner Avenue, MC 1-164, Houston, TX 77030, Telephone: 832-355-4122, Fax: 832-355-4157.






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