Clostridium difficile INFECTION IN SIDI BEL ABBES (WEST OF ALGERIA): A DESCRIPTIVE AND AN EPIDEMIOLOGICAL STUDY

Introduction: Antibiotic-associated diarrhea is frequent and is a complication which occurs in 15-20% of antibiotic treatments; in 15-20% of cases it’s due to Clostridium difficile if it causes pseudo membranous colitis.

Aim: This research has been performed to achieve the field diagnosis of infection to Clostridium difficile in Sidi Bel Abbes (West of Algeria).

Materials and Methods: From 20 September 2011 until 20 April 2012, a prospective study was developed in the service of infection and Internal Medicine, CHU of Sidi Bel Abbes on 302 patients. Statistical Analysis was developed by means of Statview software, Student´s t Test and ANOVA were included.

Results: Clostridium difficile infection (CDI) occurred in patients with a mean age of 54.65±10.54 years. The diagnosis was mainly based on the detection of Clostridium difficile toxins on stools we found 50 positive cases which were Toxin A- and Toxin B+. Our study showed that the biological inflammatory syndrome was very important in the old patients, older than 65 years old (CRP=128.65mg/L) compared to (CRP=65.85mg/L) younger than 65 years old with (Leukocytosis=15429/mm³) older than 65 years old versus 11820/mm³ younger that. A highest CRP (100mg/L) was frequently observed in the patients aged more than 65 years old compared with those aged less than 65 years old (17.24) p=0.06. In the same, the Leukocytosis was higher than 15000/mm³. 54.85% for the patients who were more than 65 years old against 19.04% to the patients who were less than 65 years old, p=0.03. A clear correlation was determined between the older age and C. difficile infection (R = 0.78, p= 0.05). Another correlation was found between C. difficile infection and the pathology especially those using antibiotics (R = 0. 83, p=0.05).

Conclusion: Our results reflect that Clostridium difficile infection is an important epidemiological problem. Thus, prevention through awareness and education as well as early detection may be improved to diminish the risk of this infection.