Evaluation of inpatients Clostridium difficile prevalence and risk factors in Cameroon

• Main Authors: Ingrid Cécile Djuikoue, Ernest Tambo, Gildas Tazemda, Omer Njajou, Denise Makoudjou, Vanessa Sokeng, Morelle Wandji, Charlène Tomi, Aubain Nanfack, Audrey Dayomo, Suzie Lacmago, Falubert Tassadjo, Raissa Talla Sipowo, Caroline Kakam, Aicha Bibiane Djoko, Clement Nguedia Assob, Antoine Andremont, Frédéric Barbut
• Format: Article
• Language: English
• Published: BMC 2020-08-01
• Series: Infectious Diseases of Poverty
• Subjects: Clostridium difficile; Prevalence; Diarrhea; Risk factors; Quinolone; Cephalosporin
• Online Access: http://link.springer.com/article/10.1186/s40249-020-00738-8

Abstract Background Clostridium difficile, rarely found in hospitals, is a bacterium responsible for post-antibiotic diarrhea and Pseudomembranous Colitis (CPM). C. difficile selective pressure represents potential public health problem due to the production of toxins A and B serious pathologies effects/consequences. A transversal and analytic study was to assess the risk factors of C. difficile infection and to determine the prevalence of C. difficile in patients received in randomly selected five hospitals in Yaoundé, Cameroon. Methods A total of 300 stool samples were collected from consented patients using a transversal and analytic study conducted from 10th July to 10th November 2018 in five hospitals in Cameroon. The detection or diagnostic kit was CerTest C. difficile Glutamate Dehydrogenase + Toxin A + Toxin B based on immuno-chromatographic assay. A univariate and multivariate analysis allowed us to highlight the associated factors. Results The results showed a prevalence of C. difficile of 27.33% (82/300 stool patients’samples taken). Of these 27.33%, the production of Toxin A and Toxin B were 37.80 and 7.31% respectively. In univariate analysis, hospitalization was a significant (P = 0.01) risk factor favoring C. difficile infection. In multivariate analysis, corticosteroids and quinolones use/administration were significantly (adjusted Odd Ratio, aOR = 14.09, 95% CI: 1.62–122.54, P = 0.02 and aOR = 3.39, 95% CI: 1.00–11.34, P = 0.05 respectively) risk factor for this infection. Conclusion The prevalence of C. difficile infections (CDI) remain high in these settings and may be related not only to permanent steroids and antibiotics. Promoting education to both medical staff and patients on the prevalence and public health impact of C. difficile can be core inimproving rationale prescription of steroids and antibiotics to patients and promote human health and exponential growth in Cameroon.