Physiciansʼ awareness level assessment of the epidemiology and diagnosis features of nosocomial infection caused by Clostridium difficile in a multidisciplinary hospitals

Cover Page
Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract


BACKGROUND: Clostridium difficile has an important place among healthcare associated infections pathogens, mainly due to the widespread and inappropriate antibiotics use. Over the past 10 years an incidence of this infection has increased in the USA and European countries. Unfortunately, C. difficile infection cases in the Russian Federation are almost not register, probably due to the lack of physicians awareness and underestimation of the pathogen role in the etiology of nosocomial infections.

AIM: Is to study the different specialties physicians awareness of C. difficile infection development in multidisciplinary hospitals.

MATERIALS AND METHODS: A questionnaire survey of 115 physicians of two multidisciplinary hospitals in Kazan was carried out. The questionnaire included 15 questions related to etiology, transmission mechanism, risk factors, clinical presentation, diagnosis and prevention of C. difficile infection. Statistical data processing was carried out in MS Excel. We used Fisher’s exact test for comparisons questionnaire responses indicators. P-values below 0.05 were considered statistically significant.

RESULTS: A low level of physicians awareness on this issue was revealed. 92.2% of physicians did not have any C. difficile infection cases in their practice. 31.3% of respondents underestimate the role of antibiotic use as the main risk factor for the development of the disease; at the same time, there are frequent cases of unreasonable prescription of antibiotics. 32.2% of the respondents are poorly informed about diagnosis methods of clostridiosis. 20% of physicians deny the role of bacteria carriers as a source of infection. 77.4% of respondents indicated the alimentary route as the main route of infection transmission. Only 38.2% of respondents noted the hospital environment objects as a possible factor in the transmission of C. difficile.

CONCLUSIONS: There is no alertness regarding antibiotic-associated diarrhea caused by C. difficile infection among multidisciplinary hospital physicians. Insufficient knowledge of epidemiology, clinical manifestations, laboratory diagnostics of C. difficile infection are factors that determine the low frequency of its detection and, accordingly, impede the implementation of required anti-epidemic measures. There is a need to include C. difficile infection issues in professional development programs for medical workers. It is advisable to develop and implement C. difficile infection control.


Full Text

Restricted Access

About the authors

Gulshat R. Khasanova

Kazan State Medical University

Email: gulshatra@mail.ru
ORCID iD: 0000-0002-1733-2576
SPIN-code: 6704-2840

Russian Federation, 49 Butlerova street, 420012 Kazan

MD, Dr. Sci. (Med.), professor

Gulnara R. Yakupova

Kazan State Medical University

Email: gulnarochka_97@mail.ru
ORCID iD: 0000-0003-2217-7352

Russian Federation, 49 Butlerova street, 420012 Kazan

6th year student of the pediatric faculty

Ksenija A. Kondratieva

Kazan State Medical University

Email: kseenia97@mail.ru
ORCID iD: 0000-0002-3004-0412

Russian Federation, 49 Butlerova street, 420012 Kazan

6th year student of the pediatric faculty

Alla Lokotkova

Kazan State Medical University

Author for correspondence.
Email: allalok12@mail.ru
ORCID iD: 0000-0003-4482-6050
SPIN-code: 5262-1969

Russian Federation, 49 Butlerova street, 420012 Kazan

к.м.н., доцент кафедры эпидемиологии и доказательной медицины

Irina A. Bulycheva

Kazan State Medical University

Email: Irishe4ka_94@mail.ru
ORCID iD: 0000-0001-7289-3037
SPIN-code: 5183-5140

Russian Federation, 49 Butlerova street, 420012 Kazan

assistant

Natalia D. Shaikhrazieva

Kazan State Medical Academy ― Branch Campus of Russian Medical Academy of Continuous Professional Education; City Clinical Hospital № 7

Email: epid-gkb7@mail.ru
ORCID iD: 0000-0002-2241-3100

Russian Federation, Kazan

MD, Cand. Sci. (Med.), associate professor

References

  1. Centers for Disease Control and Prevention. Antibiotic Use in the United States, 2017: Progress and Opportunities. Atlanta, GA: U.S. Department of Health and Human Services, CDC; 2017. Available at: https://www.cdc.gov/antibiotic-use/stewardship-report/pdf/stewardship-report.pdf. Accessed: 14.09.2020.
  2. Centers for Disease Control and Prevention. Antibiotic prescribing and use in hospitals and long-term care. Available at: https://www.cdc.gov/antibiotic-use/healthcare/index.html. Accessed: 14.09.2020.
  3. Garey KW, Graham G, Gerard L, et al. Prevalence of diarrhea at a university hospital and association with modifiable risk factors. Ann Pharmacother. 2006;40(6):1030–1034. doi: 10.1345/aph.1H028
  4. Kazanowski M. Clostridium difficile: epidemiology, diagnostic and therapeutic possibilities – a systematic review. Tech Coloproctol. 2014;18(3):223–232. doi: 10.1007/s10151-013-1081-0
  5. Lin HJ, Hung YP, Liu HC, et al. Risk factors for Clostridium difficile-associated diarrhea among hospitalized adults with fecal toxigenic C. difficile colonization. J Microbiol Immunol Infect. 2015;48(2):183–189. doi: 10.1016/j.jmii.2013.08.003
  6. Lessa FC, Mu Y, Bamberg WM, et al. Burden of Clostridium difficile infection in the United States. N Engl J Med. 2015;372(24):2368–2369. doi: 10.1056/NEJMoa1408913
  7. Riley TV, Kimura T. The epidemiology of Clostridium difficile infection in Japan: a systematic review. Infect Dis Ther. 2018;7(1):39–70. doi: 10.1007/s40121-018-0186-1
  8. McDonald LC, Lessa F, Sievert D, et al. Vital signs: preventing Clostridium difficile infections. MMWR. 2012;61(9):157–162.
  9. Centers for Disease Control and Prevention. Antibiotic Resistance Threats in the United States, 2019. Atlanta, GA: U.S. Department of Health and Human Services, CDC; 2019. Available at: https://www.cdc.gov/drugresistance/pdf/threats-report/2019-ar-threats-report-508.pdf. Accessed: 14.09.2020.
  10. Klyuchnikova IA, Petukhova IN, Grigorievskaya ZV, et al. Infections caused by Clostridium difficile in cancer patients. Sibirskiy onkologicheskiy zhurnal. 2018;17(6):92–96. (In Russ).
  11. Predrag S. Analysis of risk factors and clinical manifestations associated with Clostridium difficile disease in Serbian hospitalized patients. Braz J Microbiol. 2016;47(4):902–910. doi: 10.1016/j.bjm.2016.07.011
  12. Zakharenko SM, Ponamarev SV. The diseases associated with Clostridium difficile. Lechenie i profilaktika. 2012;3(4):82–89. (In Russ).
  13. Yarushina YN, Rudnov VA, Kolotova GB, Bagin VA. Prevalence and predictors for the development of Clostridium difficile infection in patients of the therapeutic hospital. Medical Almanac. 2019;1(58):37–40.
  14. Lobzin YuV, Zakharenko SM, Ivanov GA. Current understanding of Clostridium difficile infection. Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia. 2002;4(3):200–232. (In Russ).
  15. Surawicz CM, Brandt LJ, Binion DG, et al. Guidelines for Diognosis, treatment, and prevention of Clostridium difficile infections. Am J Gastroenterol. 2013;4(108):478–498. doi: 10.1038/ajg.2013.4
  16. Mazankova LN, Rybal’chenko OV, Nikolaeva IV. Microdisbiosis and endogenous infections. Moscow: GEOTAR-Media; 2018. 335 р. (In Russ).
  17. Akchasov SI, Sukhina MA, Sushkov OI, et al. Incidence of toxin-producing strains of Cloctridium spp. among medical staff in coloproctology department. Koloproktologiia. 2017;(4):17–23. (In Russ). doi: 10.33878/2073-7556-2017-0-4-17-23
  18. Janoir C. Virulence factors of Clostridium difficile and their role during infection. Anaerobe. 2016;37:13–24. doi: 10.1016/j.anaerobe.2015.10.009

Supplementary files

Supplementary Files Action
1.
Fig. Respondents distribution depending on the profile and duration of work.

Download (138KB) Indexing metadata

Statistics

Views

Abstract - 120

PDF (Russian) - 1

Cited-By


Article Metrics

Metrics Loading ...

Refbacks

  • There are currently no refbacks.

Copyright (c) 2020 Eco-vector



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies