An insight into Clostridium difficile infection: a single-center retrospective case-control study

2019 ◽  
Vol 57 (10) ◽  
pp. 1183-1195
Author(s):  
Fady G. Haddad ◽  
Julie Zaidan ◽  
Abhishek Polavarapu ◽  
Hafiz Khan ◽  
Asif Khan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Patient Characteristics ◽  
Healthcare Facility ◽  
Control Group ◽  
Retrospective Case ◽  
Neutrophil Lymphocyte Ratio ◽  
Factors Associated ◽  
Icu Transfer

Abstract Background Clostridium difficile infection (CDI) has become a worldwide health problem in view of its significant incidence and medical and economic impact on the health system. Prior studies have been undergone about risk factors and disease characteristics. We wanted to study the characteristics, prognostic factors associated with CDI at our institute, as well as a new prognostic factor. Methods Our study aimed at describing the risk factors, patient characteristics, and outcomes associated with healthcare facility–acquired CDI (HCFA-CDI) and community-acquired CDI (CA-CDI). We intended to identify the factors associated with worse outcomes. We evaluated the characteristics associated with CDI over 3 years. We also evaluated a simple neutrophil-lymphocyte ratio (NLR) and its predictive value for worse outcomes. Results Six hundred patients were enrolled (333 in a control group; 171 in the HCFA-CDI group and 96 in the CA-CDI group). NLR > 5 predicted increased mortality and intensive care unit transfer in all CDI if done as early as day 2 after CDI diagnosis. In HCFA-CDI, NLR > 5 predicted a higher ICU transfer if done as early as day 1 post-diagnosis and with increased mortality as early as day 2 post-diagnosis. In CA-CDI, NLR > 5 predicted a higher mortality and ICU transfer if done at least 4 days after diagnosis. Moreover, every 10-unit increase in NLR was associated with a significant increase in mortality and ICU transfer in patients with CDI. Conclusion A timely use of NLR can be used as a mean to predict worse outcomes, namely ICU transfer and mortality, in patients with CDI.

scholarly journals Risk Factors Associated With Recurrent Clostridium difficile Infection

2019 ◽  
Vol 11 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Nikhita Dharbhamulla ◽  
Ahmed Abdelhady ◽  
Mona Domadia ◽  
Sanket Patel ◽  
John Gaughan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Factors Associated ◽  
Recurrent Clostridium Difficile Infection

scholarly journals 1120. Clostridium difficile Infection Risk Factors, Severity, and Outcomes in Patients Infected with NAP1/027 Strain in a Non-Epidemic Setting

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S336-S336
Author(s):  
Julie Nahar
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Severity Of Illness ◽  
Healthcare Facility ◽  
Control Analysis ◽  
Retrospective Case ◽  
The North ◽  
Infection Risk Factors ◽  
Positive Stool Sample ◽  
Case Control Analysis

Abstract Background Evidence surrounding outcomes with the North American pulsed-field gel electrophoresis type 1 (NAP1) Clostridium difficile (CDI) strain remains conflicting. We compared risk factors, severity of illness, and mortality of patients infected with NAP1 strain compared with patients with non-NAP1 strains in our multihospital health system. Methods This is a retrospective case–control analysis of patients admitted to one of five hospitals (one academic and four community hospitals) and diagnosed with CDI from April 2014 through July 2017. CDI definition included three or more stools per day with positive stool sample polymerase chain reaction (PCR) testing for C. difficile. Results A total of 490 patients met inclusion, of which 155 had the NAP1 strain and 335 patients were infected with non-NAP1 strains. More patients with NAP1 were older, female, had CHF, and presented from a healthcare facility as opposed to from the community (all P < 0.05). No difference in 90-day antibiotic class use was found. NAP1 patients had increased ICU admission (12.3 vs. 6.0%, P = 0.016), a shorter length of stay (10.8 vs. 13.4 days, P = 0.037), abnormal CT findings (P < 0.023), and trend toward more ID consults (P = 0.067). Per IDSA classification, 61.9% in the NAP1 CDI group had severe CDI as opposed to 49.6% in the non-NAP1 study group. (P ≤ 0.038). There was no observed difference in inpatient mortality (7.7 vs. 5.7%, P = 0.381). Conclusion CDI caused by NAP1 strain did result in increased severity but did not result in increased mortality compared with CDI caused by non-NAP1 strains. Evidence continues to mount that while the NAP1 strain may affect severity, its effect on mortality remains in question. Disclosures All authors: No reported disclosures.

Risk of Clostridium Difficile Infection in Leukemia and Lymphoma Patients

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5990-5990
Author(s):  
Mohamed Abdelfatah ◽  
Amr Mohamed ◽  
Nayfe Rabih ◽  
Enriquez Kathleen ◽  
Nijim Ala ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Conflicts Of Interest ◽  
Hematologic Malignancies ◽  
Control Group ◽  
Retrospective Case ◽  
Co Morbidity ◽  
Diarrheal Episode ◽  
Morbidity Index ◽  
Group 1

Abstract Background: Clostridium difficile is the most important cause of nosocomial infectious diarrhea. The prevelance of C. difficile infection (CDI) has been poorly investigated in patients with hematologic malignancies such as leukemia and lymphoma. Purpose: To evaluate the clostridium difficile infection (CDI) incidence, severity, recurrence, developing sepsis and 30-days mortality among hospitalized patients with Leukemia and lymphoma. Methods: IRB approved retrospective case control study. 2020 patients were admitted for >48 hours in our institution between July 2007 and December 2013 with CDI, and had adequate follow up. CDI was defined as more than 3 episodes of loose stools in less than 24 hrs with a positive CD stool toxin assay. Recurrent CDI (RCDI) defined as readmission for recurrent diarrhea with 2nd positive stool test 15 days following complete resolution of previous diarrheal episode and cessation of CDI treatment. Computerized medical records to investigate demographics, laboratory blood work, Carlson Co-morbidity index, and medication used. Patients were divided into leukemia lymphoma group and control group. Group-1 included all patients with Leukemia lymphoma; AML, CML, ALL CML. Univariate predictors of CDI and multiple logistic regressions were used to assess whether patients with leukemia lymphoma had higher incidence of severity, recurrence and mortality. Controlling for Age, Serum Albumin, modified Carlson Co-morbidity index (CCI), PPI, antibiotics, and CDI treatment. Results: 2020 patients had been identified; in group-1 19 out of 95 patients (25%) had RCDI. In the control group, 364 out of 1655 patients (18%) had RCDI (p=0.614). 30-days mortality 7 out of 95 patients died within group-1 versus 157 out of 1924 in control group (p=0.799). Criteria for sepsis was fulfilled in 37 out of 95 in group-1 versus 482 out of 1924 in control group (p=0.003) Conclusion: We conclude that hospitalized patient with Leukemia and lymphoma had higher incidence of developing sepsis from CDI. There was no difference in the incidence of recurrence and 30-days mortality between patients with Leukemia lymphoma than control group. Physicians should have high suspicious for CDI in Leukemia lymphoma patients. Depend on this study we suggest early diagnosis and starting second line stronger treatment may help in decrease the incidence of CDI related sepsis. Disclosures No relevant conflicts of interest to declare.

Risk Factors Associated With Clostridium difficile Infection Recurrence in a Mexican Population

2015 ◽  
Vol 110 ◽  
pp. S590
Author(s):  
Nahum Mendez-Sanchez ◽  
Nancy Edith Aguilar-Olivos ◽  
Brenda Balderas-Garces ◽  
Cristina Gomez-Gutierrez ◽  
Victor Noffal-Nuno ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Mexican Population ◽  
Factors Associated ◽  
Infection Recurrence

Risk factors associated with Clostridium difficile infection severity in hospitalized patients

2014 ◽  
Vol 42 (6) ◽  
pp. 689-690 ◽  
Author(s):  
Mamoon A. Aldeyab ◽  
Susan Cliffe ◽  
Michael Scott ◽  
Peter Flanagan ◽  
Mary Kearney ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Hospitalized Patients ◽  
Factors Associated

Epidemiology and factors associated with candidaemia following Clostridium difficile infection in adults within metropolitan Atlanta, 2009–2013

2015 ◽  
Vol 144 (7) ◽  
pp. 1440-1444 ◽  
Author(s):  
S. VALLABHANENI ◽  
O. ALMENDARES ◽  
M. M. FARLEY ◽  
J. RENO ◽  
Z. T. SMITH ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Population Based ◽  
Case Control ◽  
Control Analysis ◽  
Factors Associated ◽  
Matched Case ◽  
Case Control Analysis

SUMMARYWe assessed prevalence of and risk factors for candidaemia following Clostridium difficile infection (CDI) using longitudinal population-based surveillance. Of 13 615 adults with CDI, 113 (0·8%) developed candidaemia in the 120 days following CDI. In a matched case-control analysis, severe CDI and CDI treatment with vancomycin + metronidazole were associated with development of candidaemia following CDI.

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