Clostridioides difficile in Latin America: A comprehensive review of literature (1984–2021).

This narrative review summarizes literature on C. difficile and C. difficile infections (CDI) that emerged from Latin America (LA) between 1984 and 2021. The revised information includes papers in English, Spanish, or Portuguese that were retrieved from the databases Pubmed, Scopus, Web of Science, Google Scholar, Scielo, and Lilacs. Information is presented chronologically and segregated in subregions, focusing on clinical presentation, risk factors, detection and typing methods, prevalence and incidence rates, circulating strains, and, when available, phenotypic traits, such as antimicrobial susceptibility patterns. Studies dealing with cases, clinical aspects of CDI, and performance evaluations of diagnostic methods predominated. However, they showed substantial differences in case definitions, measuring units, populations, and experimental designs. Although a handful of autochthonous strains were identified, predominantly in Brazil and Costa Rica, the presentation and epidemiology of CDI in LA were highly comparable to what has been reported in other regions of the world. Few laboratories isolate and type this bacterium and even less generate whole genome sequences or perform basic science on C. difficile. Less than ten countries lead academic productivity on C. difficile or CDI-related topics, and information from various countries in Central America and the Caribbean is still lacking. The review ends with a global interpretation of the data and recommendations to further develop and consolidate this discipline in LA. • We reviewed more than 200 papers published in Spanish, Portuguese, and English during almost four decades. • Most research on C. difficile in Latin America (LA) has focused on clinical aspects of CDI. • Scientific literature on CDI in LA has mainly emerged from less than 10 countries. • A need for consensus on techniques, case definitions, typing, nomenclature, and sustained funding was identified. • CDI presentation and epidemiology in LA and more developed regions of the world are highly comparable. [ABSTRACT FROM AUTHOR]