1417. Outbreak of Clostridium difficile in a Teaching Hospital in Guatemala City
Session: Poster Abstract Session: Clostridium difficile
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
  • POSTER CLOSTRIDIUM digital.jpg (472.5 kB)
  • Background:

    Clostridium difficile in hospital spreads have been reported worldwide. The role played by healthcare personal has been less well documented.
    From February through March 2013 an outbreak of Clostridium difficile gastroenteritis occurred in a Guatemalan tertiary public teaching hospital affecting both inpatients and health care providers. Inadequate adherence of existing safety measures and overcrowding of hospital facilities were considered contributing causes for the rapid spread of the Clostridium difficile infection (CDI). 


    Data from both suspected and confirmed gastroenteritis cases due to CD NAP1, of inpatients and health care personal were reviewed. Patients complained mostly of diarrhea and were suspected clinically and diagnosed by polymerase chain reaction (PCR). 


    83 infected inpatients (39♂ and 44♀; mean age 50 years 10 months) were located within 10 different wards, including 2 in a critical care unit. Three medical students were identified as vectors responsible for the spread of the CD. The rate of discharges after CDI was 955/10.000 with an attack rate of 22.37. The outbreak lasted 37 days. Mortality due to CDI was 14.4%, despite relatively early treatment. All patients who died were also immunosuppressed. 


    Initially a patient in a surgical unit was confirmed to harbour a CDI. A medical student assigned to this patient developed symptoms and was suspected to have infected two fellow medical students with whom she shared a car ride and who subsequently presented symptoms along with patients from other wards who had been exposed to these students.

    Due to early suspicion and identification of the outbreak and of initiating safety measures such as thorough cleaning of all affected units, enforcing hand washing techniques, restriction of hospital admissions, treatment of infected patients, prevention and stricter nosocomial infection surveillance, the outbreak was brought under control.

    The fact that three medical students were thought to be responsible for spreading of the disease is alarming; it is therefore imperative to insist upon more rigid hospital nosocomial safety measures.

    Johanna Samayoa, MD1, Claudia Cosenza, MD1, Carlos Mejia, MD2, Elvia Soto, GN1, Ingrid Gudiel, GN1, Remei Gordillo, MLT3, Rosa Cortes, MLT3, Diego Erdmenger, MD1, Luis O'connell, MD1 and Iris Cazali1, (1)Department of Nosocomial Diseases, Hospital Roosevelt, Guatemala, Guatemala, (2)Department Of Internal Medicine, Hospital Roosevelt, Guatemala, Guatemala, (3)Department of Microbiology, Hospital Roosevelt, Guatemala, Guatemala


    J. Samayoa, None

    C. Cosenza, None

    C. Mejia, None

    E. Soto, None

    I. Gudiel, None

    R. Gordillo, None

    R. Cortes, None

    D. Erdmenger, None

    L. O'connell, None

    I. Cazali, None

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