Clostridioides difficile epidemiology in India. (April 2022)

• Record Type: Journal Article
• Authors: Monaghan, Tanya M.; Biswas, Rima; Satav, Ashish; Ambalkar, Shrikant; Kashyap, Rajpal Singh
• Is Part Of: Anaerobe. Volume 74(2022)
• Publication Date: 2022-04
• Subjects: Antibiotic-associated diarrhea -- Clostridioides difficile -- C. difficile infection -- Epidemiology -- India; Anaerobic infections -- Periodicals; Anaerobic bacteria -- Periodicals; Bacterial diseases -- Periodicals; Computer network resources; Anaerobic protozoa -- Periodicals; 579.3
• DOI: 10.1016/j.anaerobe.2022.102517
• Languages: English
• ISSNs: 1075-9964

Abstract

Abstract: Clostridioides difficile infection (CDI) continues to affect hospitalized patients and community populations worldwide. In contrast to the substantial resources invested in the diagnosis and prevention of CDI in high-income countries, this anaerobic toxigenic bacterium has been largely overlooked in low-and-middle-income countries (LMICs) such as India, where there remains a paucity of epidemiologic data evaluating the burden of CDI. Extensive multi-institutional studies describing C. difficile epidemiology in India have not yet been performed. Given recent economic growth in many Asian countries, with aging populations, increased access to healthcare and widespread inappropriate use of antimicrobials, C. difficile is likely to be highly prevalent and causing significant disease burden. Greater efforts are required to enhance awareness of this neglected pathogen, through educating healthcare practitioners to test for CDI. There is also an urgent need to strengthen laboratory capacity, and ideally establish a national reference laboratory, to help facilitate a greater understanding of the molecular epidemiology of CDI in India and other LMICs. This mini-review aims to summarize the existing research evaluating the burden of CDI in humans and the environment in India. Highlights: Clostridioides difficile infection (CDI) is a worldwide disease that leads to significant morbidity and disease. The true prevalence of CDI in India remains largely unknown, despite the widespread use of antimicrobials. Testing for C. difficile in India is hampered by reduced clinical awareness and inadequate laboratory facilities. Governmental funding and support should focus on educational programs, highlighting standardized testing and reporting. Efforts should focus on strengthening antimicrobial stewardship to meet the rising burden of antimicrobial resistance.