Clostridioides difficile is a relevant pathogen in the etiology of infectious diarrhea associated with antimicrobial use, being responsible for increased morbidity and mortality and hospital costs. Despite its clinical relevance, Brazilian data on incidence, associated factors, and outcomes are still limited. This study aimed to describe the incidence and epidemiological profile of Clostridioides difficile infection (CDI) in a tertiary, private hospital in Porto Alegre (RS). Exploratory and retrospective study conducted between January 2024 and June 2025 in a large general hospital. Patients with compatible clinical presentation and laboratory-confirmed diagnosis by immunoassay for glutamate dehydrogenase (GDH) and toxins A/B or RT-PCR for C. difficile were included. Sixty-two episodes of CDI were identified, with an incidence of 0.56 cases per 1,000 patient-days. Median age was 79 years (IQR 60–88), and 40 (64.5%) were women. In 54.8% of cases, the infection was hospital-acquired, occurring on average 15 days after admission. Nine patients (14.5%) required ICU care and 19 (30.6%) had recurrence. Prior use of antimicrobials in the previous four weeks was identified in 57 (91.9%) cases, notably piperacillin/tazobactam (24.2%), meropenem (16.1%), cefuroxime (14.5%), and amoxicillin-clavulanate (11.3%). Digestive tract surgery was the second most common risk factor (12.9%). Thirty-day mortality was 12.9% and overall mortality was 19.4%. CDI remains a relevant challenge in Brazilian hospitals, with high recurrence and mortality rates, associated mainly with recent use of broad-spectrum antimicrobials. The scarcity of national data on incidence and resistance limits the institutional response. The importance of active surveillance, judicious antimicrobial use, and implementation of effective CDI prevention and control measures in health services is reinforced.
Paz et al. (Sun,) studied this question.