Prospective Study on Incidence, Risk Factors and Outcome of Recurrent Clostridioides difficile Infections

被引：13

作者：

Granata, Guido ^{[1
]}

Petrosillo, Nicola ^{[1
]}

Adamoli, Lucia ^{[2
]}

Bartoletti, Michele ^{[3
]}

Bartoloni, Alessandro ^{[4
]}

Basile, Gregorio ^{[4
]}

Bassetti, Matteo ^{[5
,6
,7
,8
]}

Bonfanti, Paolo ^{[9
]}

Borromeo, Raffaella ^{[10
]}

Ceccarelli, Giancarlo ^{[11
]}

De Luca, Anna Maria ^{[2
]}

Di Bella, Stefano ^{[12
]}

Fossati, Sara ^{[12
]}

Franceschini, Erica ^{[13
]}

Gentile, Ivan ^{[14
]}

Giacobbe, Daniele Roberto ^{[5
,6
]}

Giacometti, Enrica ^{[7
,8
]}

Ingrassia, Fabrizio ^{[10
]}

Lagi, Filippo ^{[4
]}

Lobreglio, Giambattista ^{[15
]}

Lombardi, Andrea ^{[16
]}

Lupo, Laura Isabella ^{[15
]}

Luzzati, Roberto ^{[12
]}

Maraolo, Alberto Enrico ^{[14
]}

Mikulska, Malgorzata ^{[5
,6
]}

Mondelli, Mario Umberto ^{[16
]}

Mularoni, Alessandra ^{[2
]}

Mussini, Cristina ^{[13
]}

Oliva, Alessandra ^{[11
]}

Pandolfo, Alessandro ^{[17
]}

Rogati, Carlotta ^{[13
]}

Trapani, Filippo Fabio ^{[3
]}

Venditti, Mario ^{[11
]}

Viale, Pierluigi ^{[3
]}

Caraffa, Emanuela ^{[1
]}

Cataldo, Maria Adriana ^{[1
]}

机构：

[1] Natl Inst Infect Dis L Spallanzani IRCCS, Clin & Res Dept Infect Dis, I-00149 Rome, Italy

[2] Infect Dis ISMETT IRCCS, I-90127 Palermo, Italy

[3] Univ Bologna, IRCCS S Orsola Teaching Hosp, Dept Med & Surg Sci, Alma Mater Studiorum, I-40126 Bologna, Italy

[4] Univ Florence, Dept Expt & Clin Med, I-50121 Florence, Italy

[5] Univ Genoa, Dept Hlth Sci DISSAL, I-16126 Genoa, Italy

[6] San Martino Polyclin Hosp IRCCS, Infect Dis Unit, I-16132 Genoa, Italy

[7] Univ Udine, Infect Dis Clin, Dept Med, I-33100 Udine, Italy

[8] Azienda Sanit Univ Integrata Udine, I-33100 Udine, Italy

[9] Monza Univ Milano Bicocca, San Gerardo Hosp, Dept Infect Dis, I-20126 Milan, Italy

[10] Hosp Crema, I-26013 Crema, Italy

[11] Sapienza Univ Rome, Dept Publ Hlth & Infect Dis, Policlin Umberto I, I-00185 Rome, Italy

[12] Azienda Sanit Univ Integrata Trieste, Dept Infect Dis, I-34128 Trieste, Italy

[13] Univ Modena & Reggio Emilia, Clin Infect Dis, I-41121 Modena, Italy

[14] Univ Naples Federico II, Infect Dis Sect, Dept Clin Med & Surg, I-80138 Naples, Italy

[15] Vito Fazzi Hosp, I-73100 Lecce, Italy

[16] Fdn IRCCS Policlin San Matteo, Div Infect Dis & Immunol, I-27100 Pavia, Italy

[17] ASST Lecco Hosp, Infect Dis, I-23900 Lecce, Italy

来源：

JOURNAL OF CLINICAL MEDICINE | 2021年 / 10卷 / 05期

关键词：

Clostridioides difficile; recurrence; risk factors; outcome; incidence;

D O I：

10.3390/jcm10051127

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Limited and wide-ranging data are available on the recurrent Clostridioides difficile infection (rCDI) incidence rate. 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: 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, p = 0.03). Conclusion: Our study confirms the relevance of rCDI in terms of morbidity and mortality and provides a reliable estimation of its incidence.

引用

页码：1 / 11

页数：11

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