Clostridioides difficile infection in a Mexico City neurological referral center Background.

Abstract

Clostridioides difficile is an important re-emerging pathogen and the primary cause of nosocomial diarrhea worldwide, particularly in high-income countries. Aim of study. To present a case series of Clostridioides difficile infection in a neurological referral center. Methods. Observational, retrospective study to present cases of C. difficile infection (CDI) in a neurological referral center in Mexico City from January 2016 to December 2018. Results. Sixteen inpatients developed CDI during the period of study. All infected patients received wide-spectrum antimicrobial therapy within six weeks before symptom onset. More than one-half of affected patients were females. Cerebrovascular disease was the main diagnosis on admission, followed by infectious diseases. Other risk factors included the administration of proton pump inhibitors, corticosteroids, and obesity. Conclusions. Neurological patients are prone to develop CDI because of a conjunction of several risk factors, indeed the concomitant use of corticosteroids, proton pump inhibitors and obesity / diabetes (before the use of extended-spectrum antibiotics). Antibiotic stewardship programs must be enforced to ensure the rational use of antibiotics in order to decrease the risk of CDI.