Characteristics, risk factors and outcomes of Clostridium difficile infections in Greek Intensive Care Units.


Journal

Intensive & critical care nursing
ISSN: 1532-4036
Titre abrégé: Intensive Crit Care Nurs
Pays: Netherlands
ID NLM: 9211274

Informations de publication

Date de publication:
Aug 2019
Historique:
received: 25 07 2018
revised: 15 03 2019
accepted: 19 03 2019
pubmed: 14 4 2019
medline: 20 12 2019
entrez: 14 4 2019
Statut: ppublish

Résumé

Clostridium difficile is one of the major causes of diarrhoea among critically ill patients and its prevalence increases exponentially in relation to the use of antibiotics and medical devices. We sought to investigate the incidence of C. difficile infection in Greek units, and identify potential risk factors related to C. difficile infection. A prospective multicenter cohort analysis of critically ill patients (3 ICUs from 1/1/2014 to 31/12/2014). Among 970(100%) patients, 95(9.79%) with diarrhoea, were included. Their demographic, comorbidity and clinical characteristics were recorded on admission to the unit. The known predisposing factors for the infection were recorded and the diagnostic tests to confirm C. difficile were conducted, based on the current guidelines. The incidence of C. difficile infection was 1.3% (n = 13). All-cause mortality in patients with diarrhoea, C. difficile infection and attributable mortality in patients with C. difficile infection was 28%, 38.5% and 30.8% respectively. Sequential Organ Failure Assessment (SOFA) scores on admission were significantly lower and prior C. difficile infection was more common in patients with current C. difficile infection. Regarding other potential risk factors, no difference was found between groups. No factor was independently associated with C. difficile infection. C. difficile infection is low in Greek intensive care units, but remains a serious problem among the critically-ill. Mortality was similar to reports from other countries. No factor was independently associated with C. difficile infection.

Sections du résumé

BACKGROUND BACKGROUND
Clostridium difficile is one of the major causes of diarrhoea among critically ill patients and its prevalence increases exponentially in relation to the use of antibiotics and medical devices. We sought to investigate the incidence of C. difficile infection in Greek units, and identify potential risk factors related to C. difficile infection.
METHODS METHODS
A prospective multicenter cohort analysis of critically ill patients (3 ICUs from 1/1/2014 to 31/12/2014).
RESULTS RESULTS
Among 970(100%) patients, 95(9.79%) with diarrhoea, were included. Their demographic, comorbidity and clinical characteristics were recorded on admission to the unit. The known predisposing factors for the infection were recorded and the diagnostic tests to confirm C. difficile were conducted, based on the current guidelines. The incidence of C. difficile infection was 1.3% (n = 13). All-cause mortality in patients with diarrhoea, C. difficile infection and attributable mortality in patients with C. difficile infection was 28%, 38.5% and 30.8% respectively. Sequential Organ Failure Assessment (SOFA) scores on admission were significantly lower and prior C. difficile infection was more common in patients with current C. difficile infection. Regarding other potential risk factors, no difference was found between groups. No factor was independently associated with C. difficile infection.
CONCLUSIONS CONCLUSIONS
C. difficile infection is low in Greek intensive care units, but remains a serious problem among the critically-ill. Mortality was similar to reports from other countries. No factor was independently associated with C. difficile infection.

Identifiants

pubmed: 30979531
pii: S0964-3397(18)30241-6
doi: 10.1016/j.iccn.2019.03.008
pii:
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Pagination

73-78

Informations de copyright

Copyright © 2019 Elsevier Ltd. All rights reserved.

Auteurs

Dimitrios K Matthaiou (DK)

Department of Critical Care Medicine, "ATTIKON" University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Dimitra Delga (D)

Department of Critical Care Medicine, "ATTIKON" University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Maria Daganou (M)

Department of Critical Care, "SOTIRIA" Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Antonia Koutsoukou (A)

Department of Critical Care, "SOTIRIA" Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Niki Karabela (N)

Department of Critical Care, "Korgialenio Benakio" Red Cross General Hospital, Athens, Greece.

Konstantinos E Mandragos (KE)

Department of Critical Care, "Korgialenio Benakio" Red Cross General Hospital, Athens, Greece.

Eleni Kalogeropoulou (E)

Department of Microbiology, "ATTIKON" University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

George Dimopoulos (G)

Department of Critical Care Medicine, "ATTIKON" University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: gdimop@med.uoa.gr.

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