Antibiotic Associated Diarrhea with Special Reference to Clostridium difficile
Journal Title: International Journal of TROPICAL DISEASE & Health - Year 2017, Vol 24, Issue 4
Abstract
Introduction: Antibiotic associated diarrhea (AAD) is a common side effect of treatment with antibiotics. Depending on the antibiotic used, up to 25% of patients experience such unpleasant bowel conditions. The normal flora is replaced by pathogenic organisms like Candida species, Clostridium difficile etc which play an important role in the causation of AAD. Almost all the antibiotics have been associated with diarrhea. C. difficile is known to occur as an outbreak in health care settings in cases of AAD. However reports from India are in-frequent. Aims: Our present study was undertaken to assess the role of different pathogen in causation of AAD and to evaluate the role of various antimicrobials in causation of AAD. Study Design: Prospective observational study. Place and Duration of Study: Department of Microbiology, B.J. Government Medical College and Sassoon General Hospital, Pune from January 2014 to December 2015. Materials and Methods: Stool samples of 70 patients developing AAD were included in the study. Individuals from all age groups were included in the study. Majority of the patients were from the age group 31 to 40 years with female preponderance Outdoor as well as Indoor patients from all faculties like medicine, surgery, obstetrics and gynecology and pediatrics were included in the present study. Samples were subjected to aerobic, anaerobic and fungal culture. C. difficile toxin was detected in stool by ELISA. PCR was also performed to look for the presence of C. difficile DNA in stool sample. Results: Ceftriaxone (55.7%) was the commonest antibiotic causing AAD followed by amoxicillin (44.3%) and amoxicillin plus clavulanic acid (41.4%). Candida species was the major pathogen isolated from 58.6% of patients. Clostridium difficile associated diarrhea either by culture, PCR or toxin detection was seen in 18.6% of patients. Aerobic pathogens were detected in 18.6% cases of AAD. Klebsiella pneumonia (8.6%) was the commonest. No pathogens were detected in 4.3% cases. Conclusion: Candida species (58.6%) is the major pathogen in AAD in our tertiary care center. However Clostridium difficile (18.6%) seems to be an emerging pathogen in our health care setting. It has been reported from the developed countries in epidemic proportions but seems to be just gaining foothold in India. Apart from stoppage of antibiotics, it is important to identify the pathogen in AAD so that appropriate management may be instituted.
Authors and Affiliations
Ankita Anand, Renu Bharadwaj, Sae Pol
Keywords
Related Articles
- EP ID EP312675
- DOI 10.9734/IJTDH/2017/34541
- Views 95
- Downloads 0
Hypertension in the Adult Population of Kaya Health and Demographic Surveillance System in Burkina Faso: Prevalence and Associated Factors
Background: Recent scientific reports have shown that high blood pressure is a major public health problem in urban populations of sub-Saharan African countries. Yet, information on this morbidity in the rural areas is l...
Vector Competence of Laboratory-reared Anopheles stephensi for Plasmodium vivax-infected Blood from Pakistani Patients
Malaria is one of the leading causes of death around the world. Plasmodium vivax is supposed to contribute over 80% of total malaria cases in Pakistan. However, data on transmission pattern is inconsistent and scanty in...
Ergonomics Workstation Assessment of Musculoskeletal Disorders in University of Port Harcourt
This study examines the experiences of musculoskeletal discomfort among staff and students of the University of Port Harcourt as it relates to their workstations. Questionnaires were designed to extract information from...
Evaluating Toxicity Profile of Garlic (Allium sativum) on the Liver, Kidney and Heart Using Wistar Rat Model
Background: The medicinal values of Allium sativum has been extensively described in a number of studies. Additionally, it has shown antimicrobial activity against a wide spectrum of microorganism; bacteria, fungi and pa...
High Prevalence of Isolated Hepatitis B Core Antibody among Adults in Oyo State, Nigeria: The Need for Review of Diagnostic and Vaccination Guidelines
Background: Ten years of neonatal immunization with hepatitis B vaccine has not had any significant effect on the prevalence of the disease in Nigeria. Aim: To investigate hepatitis B virus (HBV) markers as potential ris...