Clostridium difficile, an emerging infection in chronic hemodialysis patients

Author: 
Hussein Yousif Salem, Fakhriya Alalawi, Maseer Ahmed, Sima Najad, Hany Tobia and Amna Alhadari

Background: Patients of the chronic renal disease require repeated hemodialysis and are hospitalized frequently. They are prone to nosocomial infections of which- the Clostridium difficle is common. It can be very lethal if diagnosed lately or have resistant strain as a causative organism.
Objective: To document the frequency of C. difficle infection among patients of chronic hemodialysis and its associated outcomes.
Study design: Retrospective study.
Settings: Department of Nephrology, Dubai Hospital, Dubai.
Material and methods: Data of a total of 18 cases of hemodialysis having diagnosed as C. difficle infection, both genders, age 45-85 years were extracted from medical records of SALAMA system and laboratory tests registry. All data were collected and recorded in Performa. Statistical Program for Social Sciences (SPSS) version 19 was used to analyze the data.
Results: Mean ± SD age was 70.94 ± 11.51 years (Range 48-84). The majority (83.3%) were females. One-third of patients were of age >81 years. Hypertension and diabetes mellitus were common comorbidities. Patients presented with Gastroenteritis (22.2%), Chest infection with CO2 retention (16.7%). One-third of patients were treated with Metronidazole while 61% needed vancomycin in addition. Total 02 patients (5.55%) could not survive both of which were females and were age 72 & 73 years respectively, however, their direct cause of death were unlikely related to CDI.
Conclusion: C.difficle continues to affect the old age, female and chronically ill patients. Their healthcare providers, as well as the patients, need to be educated for the prevention of unnecessary and overuse of antimicrobials.

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DOI: 
http://dx.doi.org/10.24327/ijcar.2019.19364.3731
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