<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022022000300022</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Infecciones por Clostridioides (Clostridium) difficile en un hospital geriátrico de Costa Rica]]></article-title>
<article-title xml:lang="en"><![CDATA[Clostridioides (Clostridium) difficile infections in a geriatric hospital in Costa Rica]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jiménez-Badilla]]></surname>
<given-names><![CDATA[Iveth]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodríguez-González]]></surname>
<given-names><![CDATA[María José]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Camacho-Mora]]></surname>
<given-names><![CDATA[Zianne]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Quesada-Gómez]]></surname>
<given-names><![CDATA[Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Caja Costarricense del Seguro Social Hospital Dr. Fernando Escalante Pradilla Laboratorio Clínico, Pérez Zeledón]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Caja Costarricense del Seguro Social Centro Especializado de Atención de Pacientes con COVID-19 Laboratorio Clínico]]></institution>
<addr-line><![CDATA[La Uruca San José]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Caja Costarricense del Seguro Social Hospital Nacional de Geriatría y Gerontología Dr. Raúl Blanco Cervantes Laboratorio Clínico]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Universidad de Costa Rica Facultad de Microbiología Centro de Investigación en Enfermedades Tropicales]]></institution>
<addr-line><![CDATA[San Pedro San José]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2022</year>
</pub-date>
<volume>64</volume>
<numero>3</numero>
<fpage>22</fpage>
<lpage>30</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022022000300022&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022022000300022&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022022000300022&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Objetivo:  Describir las características de los pacientes adultos mayores con diagnóstico de infecciones por Clostridium difficile en un hospital geriátrico en Costa Rica con el propósito de contribuir a mejorar su manejo y llevar a una reducción de la morbimortalidad y costos asociados a su atención.  Métodos:  Se realizó un estudio observacional retrospectivo con información demográfica y clínica de 141 pacientes admitidos en el Hospital Nacional de Geriatría y Gerontología Dr. Raúl Blanco Cervantes de Costa Rica del 2015 al 2018, quienes presentaron una prueba inmunocromatográfica de detección de antígeno y/o toxinas de C. difficile positiva en heces diarreicas. Las variables continuas se compararon mediante una prueba de ANOVA, mientras que las categóricas, por una prueba exacta de Fisher. Los factores de riesgo para cada uno de los grupos se evaluaron por análisis univariante. Los valores de p &lt; 0,05 se consideraron estadísticamente significativos con un 95% de confianza.  Resultados:  Se estudiaron 141 pacientes con diarrea asociada a C. difficile. Los pacientes tenían una edad promedio de 83 años y 57% eran mujeres. Un 35% de los casos eran de origen comunitario y 27% fueron severos. El consumo de antimicrobianos fue dado principalmente por cefalosporinas y fluoroquinolonas. El tratamiento más utilizado fue el metronidazol (81%) y la mortalidad relacionada con la infección por C. difficile a los 30 días fue de un 35%.  Conclusiones:  Este es el primer reporte epidemiológico de infección por C. difficile que describe a un grupo de pacientes geriátricos hospitalizados y sus factores de riesgo asociados, que pone en manifiesto un porcentaje importante de casos comunitarios y graves, lo que llama a establecer guías locales y grupos específicos para el tratamiento y prevención de dicha infección.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Aim:  To describe the characteristics of elder patients diagnosed with Clostridioides (Clostridium) difficile infection in a geriatric hospital in Costa Rica.  Methods:  A retrospective observational study was done with demographic and clinical information from 141 patients admitted in the National Geriatric and Gerontology Hospital of Costa Rica from 2015 to 2018, who presented a positive immunochromatographic test for the detection of C. difficile antigen and/or toxins in diarrheic feces. Continuous variables were compared through one-way ANOVA test, while categorical variables were compared using Fisher's exact test. The risk factors for each of the groups were evaluated by univariate analysis. P values &lt; 0.05 were considered statistically significant with 95% confidence.  Results:  We studied 141 patients with diarrhea associated with C. difficile, the average age of the patients was 83 years and 75% were women. 35% of the cases were community acquired and 27% were severe cases. Antimicrobial consumption was given mainly by cephalosporins and fluoroquinolones. Metronidazol was the most used treatment (81%) and the C. difficile associated mortality 30 days post infection was 35%.  Conclusion:  This is the first epidemiological report of C. difficile infection in elderly hospitalized population. Also, it evidences an important percentage of community acquired and severe cases, calling for the establishment of local treatment and prevention guidelines for this infection.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Clostridioides difficile]]></kwd>
<kwd lng="es"><![CDATA[hospitales geriátricos]]></kwd>
<kwd lng="es"><![CDATA[diarrea]]></kwd>
<kwd lng="es"><![CDATA[Costa Rica]]></kwd>
<kwd lng="en"><![CDATA[Clostridioides difficile]]></kwd>
<kwd lng="en"><![CDATA[geriatric hospitals]]></kwd>
<kwd lng="en"><![CDATA[diarrhea]]></kwd>
<kwd lng="en"><![CDATA[Costa Rica]]></kwd>
</kwd-group>
</article-meta>
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