Prospective Study on Incidence, Risk Factors and Outcome of Recurrent
Clostridioides difficile
incidence
outcome
recurrence
risk factors
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
08 Mar 2021
08 Mar 2021
Historique:
received:
29
12
2020
revised:
03
02
2021
accepted:
19
02
2021
entrez:
3
4
2021
pubmed:
4
4
2021
medline:
4
4
2021
Statut:
epublish
Résumé
Limited and wide-ranging data are available on the recurrent We performed a cohort study with the aim to assess the incidence of and risk factors for rCDI. Adult patients with a first CDI, hospitalized in 15 Italian hospitals, were prospectively included and followed-up for 30 d after the end of antimicrobial treatment for their first CDI. A case-control study was performed to identify risk factors associated with 30-day onset rCDI. Three hundred nine patients with a first CDI were included in the study; 32% of the CDI episodes (99/309) were severe/complicated; complete follow-up was available for 288 patients (19 died during the first CDI episode, and 2 were lost during follow-up). At the end of the study, the crude all-cause mortality rate was 10.7% (33 deaths/309 patients). Two hundred seventy-one patients completed the follow-up; rCDI occurred in 21% of patients (56/271) with an incidence rate of 72/10,000 patient-days. Logistic regression analysis identified exposure to cephalosporin as an independent risk factor associated with rCDI (RR: 1.7; 95% CI: 1.1-2.7, Our study confirms the relevance of rCDI in terms of morbidity and mortality and provides a reliable estimation of its incidence.
Sections du résumé
BACKGROUND
BACKGROUND
Limited and wide-ranging data are available on the recurrent
METHODS
METHODS
We performed a cohort study with the aim to assess the incidence of and risk factors for rCDI. Adult patients with a first CDI, hospitalized in 15 Italian hospitals, were prospectively included and followed-up for 30 d after the end of antimicrobial treatment for their first CDI. A case-control study was performed to identify risk factors associated with 30-day onset rCDI.
RESULTS
RESULTS
Three hundred nine patients with a first CDI were included in the study; 32% of the CDI episodes (99/309) were severe/complicated; complete follow-up was available for 288 patients (19 died during the first CDI episode, and 2 were lost during follow-up). At the end of the study, the crude all-cause mortality rate was 10.7% (33 deaths/309 patients). Two hundred seventy-one patients completed the follow-up; rCDI occurred in 21% of patients (56/271) with an incidence rate of 72/10,000 patient-days. Logistic regression analysis identified exposure to cephalosporin as an independent risk factor associated with rCDI (RR: 1.7; 95% CI: 1.1-2.7,
CONCLUSION
CONCLUSIONS
Our study confirms the relevance of rCDI in terms of morbidity and mortality and provides a reliable estimation of its incidence.
Identifiants
pubmed: 33800334
pii: jcm10051127
doi: 10.3390/jcm10051127
pmc: PMC7962640
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
Clin Infect Dis. 2015 May 15;60 Suppl 2:S66-71
pubmed: 25922403
Clin Microbiol Infect. 2014 Mar;20 Suppl 2:1-26
pubmed: 24118601
Infect Control Hosp Epidemiol. 2015 Apr;36(4):452-60
pubmed: 25626326
Clin Infect Dis. 2005 Jun 1;40(11):1591-7
pubmed: 15889355
Clin Infect Dis. 2016 Mar 1;62(5):574-580
pubmed: 26582748
Am J Gastroenterol. 2012 Jul;107(7):1079-87
pubmed: 22450732
Microb Pathog. 2015 Dec;89:201-9
pubmed: 26549493
N Engl J Med. 2010 Jan 21;362(3):197-205
pubmed: 20089970
Am J Gastroenterol. 2002 Jul;97(7):1769-75
pubmed: 12135033
Patient. 2014;7(1):97-105
pubmed: 24403096
Clin Infect Dis. 2006 Mar 15;42(6):758-64
pubmed: 16477549
Euro Surveill. 2016 Jul 21;21(29):
pubmed: 27470194
N Engl J Med. 2014 Mar 27;370(13):1198-208
pubmed: 24670166
Clin Microbiol Infect. 2015 Feb;21(2):164-70
pubmed: 25658560
Clin Microbiol Infect. 2012 Dec;18 Suppl 6:21-7
pubmed: 23121551
Curr Opin Gastroenterol. 2009 Jan;25(1):24-35
pubmed: 19114771
PLoS One. 2014 Jun 04;9(6):e98400
pubmed: 24897375