The Analysis of Risk Factors and Clinical-Demographic Characteristics of Patients with Clostridium Dificille Infection as Well as The Outcome of Their Treatment

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Abstract

Pseudomembranous colitis is a frequent nosocomial infection associated with significant morbidity and mortality. Clostridium difficile infection incidence most frequently increases due to unreasonable antibiotic use and the appearance of new hypervirulent bacterial strains, which leads to prolonged hospitalization and an increase in the total cost of hospital treatment.

This is a retrospective design study conducted at Clinical Centre Kragujevac from January to December 2014. The patient data were obtained from the protocol of the Virological Laboratory and from medical documentation. All statistical analyses were performed using the computer program SPSS. The descriptive statistical data are expressed as percentage values. Continuous variables are expressed as the arithmetic mean with the standard deviation.

Clostridium difficile infection occurred more frequently with elderly patients (123 patients were over 65 years old). Out of 154 patients on antibiotic treatment, 110 patients were treated with a combination of two or more antibiotics from different pharmacological groups. The most represented antibiotics were from the cephalosporin (71.4%) and quinolone (46.3%) groups. A total of 85.8% of the patients used proton pump inhibitors and H2 blockers.

Our results describe the clinical and demographic characteristics of patients with diagnosed Clostridium difficile infection. The most prevalent characteristics (age, antibiotic therapy, PPI and H2 blocker use), which other researchers have also mentioned as risk factors, were present in our study as well.

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  • 1. Moudgal V Sobel JD. Clostridium difficile colitis: a review. Hosp Pract (1995). 2012; 40(1): 139-48.

  • 2. Furuya-Kanamori L Stone JC Clark J McKenzie SJ Yakob L et al. Comorbidities Exposure to Medications and the Risk of Community-Acquired Clostridium difficile Infection: a systematic review and meta-analysis. Infect Control Hosp Epidemiol. 2015; 36(2): 132-41.

  • 3. Gao T He B Pan Y Deng Q Sun H et al. Association of Clostridium difficile infection in hospital mortality: A systematic review and meta-analysis. Am J Infect Control. 2015; 43(12): 1316-20.

  • 4. Goodhand JR Alazawi W Rampton D. Systematic review: Clostridium difficile and inflammatory bowel disease. Aliment Pharmacol Ther. 2011; 33(4): 428-41.

  • 5. Bavishi C DuPont HL. Systematic review: the use of proton pump inhibitors and increased susceptibility to enteric infection. Alimen Pharmacol Ther 2011; 34: 1269-81.

  • 6. Kwok CS Arthur AK Anibueze CI Singh S Cavallazzi R et al. Risk of Clostridium difficile infection with acid suppressing drugs and antibiotics: meta-analysis. Am J Gastroenterol. 2012; 107(7): 1011-9.

  • 7. Janarthanan S Ditah I Adler DG Ehrinpreis MN. Clostridium difficile-associated diarrhea and proton pump inhibitor therapy: a meta-analysis. Am J Gastroenterol. 2012; 107: 1001-10.

  • 8. Bauer MP Notermans DW van Benthem BH Brazier JS Wilcox MH еt al. Clostridium difficile infection in Europe: a hospital-based survey. Lancet. 2011; 377(9759): 63-73.

  • 9. Surowiec D Kuyumjian AG Wynd MA Cicogna CE. Past present and future therapies for Clostridium difficile-associated disease. Ann Pharmacother 2006; 40: 2155 - 63.

  • 10. Deshpande A Pasupuleti V Thota P Pant C Rolston DD et al. Community-associated Clostridium difficile infection and antibiotics: a meta-analysis. J Antimicrob Chemother. 2013; 68(9): 1951-61.

  • 11. Brown KA Khanafer N Daneman N Fisman DN. Meta- analysis of antibiotics and the risk of communityassociated Clostridium difficile infection. Antimicrob Agents Chemother. 2013; 57(5): 2326-32.

  • 12. Dial S Alrasadi K Manoukian C Huang A Menzies D. Risk of Clostridium difficile diarrhea among hospital inpatients prescribed proton pump inhibitors: cohort and case-control studies. CMAJ. 2004; 171: 33-8.

  • 13. Kelly CP LaMont JT. Clostridium difficile-more difficult than ever. N Engl J Med. 2008; 359(18): 1932-40.

  • 14. Tang-Feldman Y Mayo S Silva J Jr et al. Molecular аnalysis of Clostridium difficile strains isolated from 18 cases of recurrent Clostridium difficile-associated diarrhea. J Clin Microbiology 2003; 41: 3413-4.

  • 15. Hookman P Barkin JS. Clostridium difficile associated infection diarrhea and colitis. World J Gastroenterol 2009; 15: 1554-80.

  • 16. Arvand M Hauri AM Zaiss NH Witte W Bettge- Weller G. Epidemiology of severe Clostridium difficile infections in Hesse Germany in 2008-2009. Dtsch Med Wochenschr 2010; 135(40): 1963-7.

  • 17. Goodhand JR Alazawi W Rampton D. Systematic review: Clostridium difficile and inflammatory bowel disease. Aliment Pharmacol Ther 2011; 33(4): 428-41.

  • 18. Bajaj JS O’Leary JG Reddy KR Wong F Olson JC et al. Second infections inde-pendently increase mortality in hospitalized patients with cirrhosis: the North American сonsortium for the study of end-stage liver disease (NACSELD) experience. Hepatology 2012; 56(6): 2328-35.

  • 19. Di X Bai N Zhang X Liu B Ni W et al. A meta-analysis of metronidazole and vancomycin for the treatment of Clostridium difficile infection stratified by disease severity. Braz J Infect Dis. 2015; 19(4):339-49

  • 20. Shafran DM Shafran SD. Treating Clostridium difficile infection. CMAJ. 2014;186: 7.

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