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Medline ® Abstract for Reference 84

of 'Approach to acute abdominal pain in pregnant and postpartum women'

84
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Clostridium difficile-associated diarrhea: an emerging threat to pregnant women.
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Rouphael NG, O'Donnell JA, Bhatnagar J, Lewis F, Polgreen PM, Beekmann S, Guarner J, Killgore GE, Coffman B, Campbell J, Zaki SR, McDonald LC
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Am J Obstet Gynecol. 2008;198(6):635.e1.
 
OBJECTIVE: To estimate if Clostridium difficile-associated disease (CDAD) is increasing in peripartum women.
STUDY DESIGN: Peripartum CDAD was assessed through 1) passive surveillance collecting clinical and pathology data on severe cases and 2) survey among infectious disease consultants (ICDs) in the Emerging Infections Network.
RESULTS: Ten severe cases were collected; most had associated antibiotic use. Seven women were either admitted to the ICU or underwent colectomy. Three infants were stillborn, and 3 women died. The epidemic Clostridium difficile strain was found in 2 cases. Among 798 ICDs, 419 (52%) participated in the survey. Thirty-seven respondents (9%) recalled 55 cases, mostly in the postpartum period with 21 complications, mainly due to relapse.
CONCLUSION: Severe CDAD may be increasing in peripartum women. Clinicians should have a low threshold for testing, be aware of the potential for severe outcomes, and take steps to reduce both the risk of disease and resultant complications.
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Division of Bacterial Diseases, Epidemic Intelligence Service Field Assignments Branch,Centers for Disease Control and Prevention, Atlanta, GA, USA.
PMID