Epidemiological features of infections caused by Clostridium difficile

Abstract

Introduction. Clostridium difficile has been intensively studied in recent years due to the rapid increase in the number of people affected by the virulence of this bacterium. The bacterium has become very resistant to different treatment methods,epidemiological studies prove that there are several factors that have contributed to this phenomenon:the administration of antibiotics without medical prescription and the appearance of a new strain known as PCR ribotype 027(sometimes referred to as BI/NAP1/027. Aim of study. We analyzed the epidemiological data from the Republic of Moldova and globally regarding the level of knowledge of the population and medical workers regarding the adverse effects of antibiotics, which is a risk factor in triggering the multiplication of the bacterium Clostridium difficile. The epidemiological data that demonstrate the rapid and partially uncontrolled spread of the bacterium. Methods and materials. Epidemiological data analysis was based on articles published on Google Scholar, PubMed, Journal.ohrm and other platforms. Results. Clostridium difficile - a "dangerous" gram-positive, anaerobic, mobile, sporogenous bacterium that is in the normal flora of every human's intestine. The CDI bacterium forms spores that are extremely resistant in the external environment (several months), increased resistance to alcohol disinfectants and sensitive to chlorine-containing disinfectants. The normal flora of the small intestine contains over 2000 types of bacteria that are essential for health. Exposure to certain aggressive factors trigger the colonization and multiplication of the pathogenic bacterium Clostridium difficile. This bacterium was studied for the first time in 1970, until now worldwide it causes approximately 500,000 cases of illness, in the Republic of Moldova CDI is not monitored epidemiologically, but it has become one of the most frequent infections acquired between hospitals. .It mainly affects people over 60-65 years admitted to the hospital, the reason being the suppression of immunity. In Romania, due to the dramatic increase in the number of infected people, an "ATLAS" Score was launched, used to analyze the evaluation of the disease after confirmation, the parameters of this score are: age, fever, number of leukocytes, albumin, the antibiotic administered. A study presented by Garcia et al. demonstrated that after 30 days of illness the patient who has a score of <3 points were treated without sequelae 100%, the patients with the score: >8 died 100%, the patients with the score between 4 and 7 points are subjected to surgical treatment which consists of intestinal resection, with a 70.1% survival rate. Conclusion. It is necessary in the Republic of Moldova to implement methods of identification, monitoring and reporting of the number of cases of infection with CDI, in order to be able to control the infection.