Analyzing the outcome of clostridium difficile infection in cancer patients.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19340-e19340
Author(s):  
Kamal Kant Sahu ◽  
Ajay Mishra ◽  
Susan V George ◽  
George Abraham ◽  
Ahmad Daniyal Siddiqui
Keyword(s):  
Clostridium Difficile ◽  
Cancer Patients ◽  
Clostridium Difficile Infection ◽  
P Value ◽  
Nursing Facility ◽  
Factors Affecting ◽  
Patients With Cancer ◽  
History Of ◽  
Study Population ◽  
Qsofa Score

e19340 Background: Clostridium difficile infection (CDI) is a considerable health burden, and now identified as the leading cause of acquired diarrhea in patients receiving antibiotics. Cancer patients are more prone to acquire CDI, owing to their frequent exposure to risk factors. This study aims to investigate the factors affecting the outcome of Clostridium Difficile Infection in patients with cancer at our community center. Methods: This is a retrospective study that included a total of 59 cancer patients who were hospitalized for clostridium difficile infection. Results: The median age of the study population was 79 years with 39 males and 20 females. The patients were suffering from cancer located at the following sites: Prostate (25), lung (19), colon (7), bladder (4), breast (3) and renal (1). There were 52 cases of 1st and 7 cases of recurrent CDI admissions. 40 patients detected to have CDI at presentation while 19 patients developed CDI during hospitalization. CDI categories were as follows: Non-severe (29), severe (28), and very severe (3). There were 33 and 20 patients on chemotherapy and radiotherapy respectively. 27 patients had a recent history of cancer care-related procedures or interventions. 29 patients were from either rehab or nursing facility. There were 39 recent hospitalizations with 29 patients receiving antibiotics. Almost half of the patients were on PPI (29) and 12 were on steroids (20.3%) at the time of developing CDI. Patients with a high-risk qSOFA Score of 2 or more (p-value = 0.008) or a high white blood cell count of > 15 X 109/L (p-value = 0.016) were found to have higher in-hospital mortality. Critical care data suggested that 9 patients required intensive care, 7 patients required vasopressor support, and 6 needed mechanical ventilation. Patients were treated with either vancomycin alone (13), or metronidazole alone (25), or combination therapy with vancomycin + metronidazole (21). The median duration of hospital stay was 6 days with 11 fatalities (18.64%). Conclusions: CDI causes significant morbidity in cancer patients. Factors like high qSOFA score and leukocytosis can help to prioritize and intensify the care and in prognosticating the patients.

scholarly journals 2392. Identifying Associations Between Clostridium difficile Infection Incidence and Cancer Patients Receiving Chemotherapy

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S826-S826
Author(s):  
Vincent Louie Mendiola ◽  
Meghana Kesireddy ◽  
Krishna Suthar ◽  
Maurice Willis
Keyword(s):  
Clostridium Difficile ◽  
Cancer Patients ◽  
Clostridium Difficile Infection ◽  
Financial Burden ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
P Value ◽  
Retrospective Case ◽  
Equal Variance ◽  
Medical Histories

Abstract Background Clostridium difficile infection (CDI) is a known major financial burden. In the cancer population, CDI, was identified to have a peak incidence of 17.2 per 1000 patients with increased morbidity, mortality and hospital length of stay. The need to further elucidate chemotherapy (CTX) with vs. without ABX usage as risk factors among other variables in cancer patients arises since this population is already baseline immunocompromised. Methods A retrospective case–control study (total of 1989 cancer patients who received CTX and had diarrhea at UTMB through 1/2016–1/2018) was completed. Subjects were screened using extensive inclusion and exclusion criteria, and assigned as CASES (with symptomatic (s) diarrhea from proven CDI) and as CONTROLS (had diarrhea but not attributed to CDI). A 1:1 subject matching using age, sex and past medical histories was completed and a total of 46 patients: 23 cases and 23 controls were compared and analyzed. McNemar’s and independent t test of equal variance were used for association and comparing means/medians, respectively. Two-sided P value ≤ 0.05 was considered significant. Results The use of ABX (OR = 16, P = 0.0007) and having any degree of neutropenia at the time of diarrhea (OR = 12, P = 0.0055) among CTX patients had significant associations with having sCDI. Although no significant association between sCDI and # of days post CTX exposure (≥7 days (P = 0.1138) and ≥14 days post CTX (P = 0.1489) was identified, a mean of 12.83 ± 7.69 days passed before sCDI diagnosis in cases, compared with diarrhea diagnosis (7.46 ± 6.1 days) in controls (P = 0.0119). Meanwhile, receiving >1 CTX cycle (P = 1.000) and particular CTX types (P = ~ 0.0771–1.000) had no significant associations with sCDI diagnosis. Conclusion Any ABX usage post CTX exposure heavily predisposes to sCDI among cancer patients likely due to elimination of gut flora on an already predisposed population. Having any degree of neutropenia was also associated with having sCDI likely due to significant immunosuppression on top of being baseline cancer patients receiving CTX, and may have predictability benefits. The other variables may have not been significant due to expected limited cases because of low CDI incidence. Disclosures All authors: No reported disclosures.

scholarly journals RELATIONSHIP BETWEEN DEMOGRAPHIC CHARACTERISTICS AND SPIRITUAL WELLBEING AMONG CANCER SURVIVORS

2017 ◽  
Vol 3 (4) ◽  
pp. 405-411 ◽  
Author(s):  
Eviwindha Suara ◽  
Mardiyono Mardiyono ◽  
Anggorowati Anggorowati
Keyword(s):  
Cancer Patients ◽  
Demographic Characteristics ◽  
P Value ◽  
Spiritual Wellbeing ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Patients With Cancer ◽  
Significant Relationships ◽  
Gender Education ◽  
Important Quality

Background: Spiritual wellbeing (SWB) is an important quality-of-life dimension for cancer patients. Therefore, health professionals are demanded to improve SWB in these patients. A deeper understanding regarding the factors associated with SWB is needed.Objective: This study aims to examine the relationships of demographic characteristics of patients and spiritual wellbeing in patients with cancer.Methods: This was a cross-sectional correlational study with 60 respondents recruited using consecutive sampling. A spiritual wellbeing scale (SWBS) was used, and data were analyzed using Kendall's Tau and Spearman's rank.Results: Findings in this study showed that only age was statistically significant with spiritual wellbeing of cancer patients with p-value 0.003 (<0.05). There were no significant relationships of gender, education, occupation, long suffering, and type of cancers with spiritual wellbeing with p-value >0.05.Conclusion: There was a significant relationship between age and spiritual wellbeing in patients with cancer. This study provides the insight of knowledge regarding the factors affecting spiritual wellbeing in patients with cancer.

scholarly journals Hubungan Perilaku Caring Perawat Dengan Tingkat Harapan Sembuh Pada Pasien Kanker Yang Menjalani Program Kemoterapi Di Rumah Sakit Baladhika Husada Jember

2020 ◽  
Vol 23 (3) ◽  
pp. 169-177
Author(s):  
Alvinda Apriliatul Jannah ◽  
Anisah Ardiana ◽  
Retno Purwandari
Keyword(s):  
Social Support ◽  
Cancer Patients ◽  
Cross Sectional Study ◽  
Patient Comfort ◽  
P Value ◽  
Cross Sectional ◽  
Patients With Cancer ◽  
Caring Behavior ◽  
Nurse Caring ◽  
The Relationship

Hope is a crucial issue in patients with cancer. Hope can be increased by providing social support. Social support can be obtained from the nurses caring behavior. This research aimed to analyze the relationship between nurses caring behavior and recovery hope level of cancer patients undergoing chemotherapy program at Baladhika Husada Hospital in Jember. A cross-sectional study was conducted to 112 respondents using the Caring Behavior Inventory (CBI-24) questionnaire and Scale of Hope. The data were analyzed applying the Kendall Tau B (τ) correlation. The results showed that there was a relationship between nurses caring behavior with the level of recovery expectancy of cancer patients undergoing chemotherapy programs at Baladhika Husada Hospital in Jember (p-value <0.001; τ = 0.375). Nurse caring behavior increases patient comfort and makes patients more enthusiastic about undergoing therapy. Patients feel valued and get more information from nurses. Therefore, the patient's recovery hopes can increase. This study concludes that nurses caring behavior can increase the expectation of recovery of cancer patients. Abstrak Harapan adalah hal krusial pada pasien kanker. Harapan dapat ditingkatkan dengan pemberian dukungan sosial yang bisa didapat dari perilaku caring perawat. Tujuan dari penelitian ini adalah untuk menganalisis hubungan perilaku caring perawat dengan tingkat harapan sembuh pasien kanker yang menjalani program kemoterapi di Rumah Sakit Baladhika Husada Jember. Penelitian ini menggunakan metode cross sectional dan 112 responden didapatkan dengan teknik sampel purposive samping. Data didapatkan melalui kuesioner CBI-24 dan kuesioner skala harapan. Analisis pada penelitian ini menggunakan uji korelasi Kendall Tau B (τ). Hasil menunjukkan terdapat hubungan antara perilaku caring perawat dengan tingkat harapan sembuh pasien kanker yang menjalani program kemoterapi di Rumah Sakit Baladhika Husada Jember (p value < 0,001; τ = 0,375). Perilaku caring perawat dapat meningkatkan kenyamanan pasien dan membuat pasien lebih semangat menjalankan terapi yang dijalani. Pasien merasa dinilai dan mendapatkan informasi lebih dari perawat. Maka dari itu, harapan sembuh pasien dapat meningkat. Kesimpulan dari penelitian ini adalah perilaku caring perawat dapat meningkatkan harapan sembuh pasien kanker.  

scholarly journals Fecal calprotectin concentrations in cancer patients with Clostridium difficile infection

2018 ◽  
Vol 37 (12) ◽  
pp. 2341-2346 ◽  
Author(s):  
Taojun He ◽  
Samuel E. Kaplan ◽  
Luz A. Gomez ◽  
Xuedong Lu ◽  
Lakshmi V. Ramanathan ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Cancer Patients ◽  
Clostridium Difficile Infection ◽  
Fecal Calprotectin

scholarly journals Application of the Stress and Anxiety to Viral Epidemics-6 (SAVE-6) and Coronavirus Anxiety Scale (CAS) to Measure Anxiety in Cancer Patient in Response to COVID-19

2020 ◽  
Vol 11 ◽  
Author(s):  
Myung Hee Ahn ◽  
Jihoon Lee ◽  
Sooyeon Suh ◽  
Sangha Lee ◽  
Hwa Jung Kim ◽  
...  
Keyword(s):  
Mental Health ◽  
Cancer Patient ◽  
Cancer Patients ◽  
Social Adjustment ◽  
Functional Impairment ◽  
Anxiety Scale ◽  
Online Questionnaire ◽  
Patients With Cancer ◽  
Study Population ◽  
Social Adjustment Scale

This study investigated the usefulness of the six-item Stress and Anxiety to Viral Epidemics (SAVE-6) scale and the Coronavirus Anxiety Scale (CAS) as tools to assess anxiety related to coronavirus disease (COVID-19) in cancer patients. A total of 221 patients with cancer responded to an anonymous online questionnaire between 15 July and 15 August 2020. The functional impairment of the patients was assessed using the Work and Social Adjustment Scale (WSAS), and the SAVE-6 and CAS were also applied. Among these 221 cancer patients, 110 (49.8%) had SAVE-6 scores ≥ 15 and 21 (9.5%) had CAS scores ≥ 5. Within the study population, 104 (47.1%) and 29 (13.1%) patients had WSAS scores ≥ 11 (moderate to severe functional impairment) and ≥ 21 (severe functional impairment), respectively. The correlations between the SAVE-6 and WSAS (p &lt; 0.001) and CAS (p &lt; 0.001) scores were statistically significant. The cut-off for the SAVE-6 was 15 points, while that for the WSAS was 11. Our results suggested that the SAVE-6 and CAS could be used to evaluate moderate and severe degrees of functional impairment related to mental health, respectively, in cancer patients during viral epidemics.

scholarly journals Factors affecting development of Clostridium difficile infection in hospitalized pediatric patients in the country Georgia

2018 ◽  
Vol 11 (1) ◽  
Author(s):  
Iuri Migriauli ◽  
Vakhtang Meunargia ◽  
Ivane Chkhaidze ◽  
Giorgi Sabakhtarishvili ◽  
Kakha Gujabidze ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Pediatric Patients ◽  
Factors Affecting

scholarly journals 3442 Among Hospitalized Patients, Cannabis use is Associated with Reduced risk of Clostridium Difficile infection

2019 ◽  
Vol 3 (s1) ◽  
pp. 33-34
Author(s):  
Adeyinka Charles Adejumo ◽  
Terence Ndonyi Bukong
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Hospitalized Patients ◽  
Cannabis Use ◽  
Care Utilization ◽  
P Value ◽  
Adjusted Relative Risk ◽  
Increased Risk ◽  
The Impact ◽  
Reduced Risk

OBJECTIVES/SPECIFIC AIMS: Clostridium Difficile Infection (CDI), a prevalent cause of diarrhea, is the most notorious hospital-acquired infection, resulting in an alarming mortality and health care utilization rates. Herein, we investigate the impact of cannabis use, which is gaining significant legalization for recreational use, on the risk of CDI. METHODS/STUDY POPULATION: We selected adult records (age ≥ 18 years) from the Nationwide Inpatient Sample 2014, and identified cannabis users and other clinical conditions using ICD-9-CM codes. With multivariate logistic modeling, we generated propensity scores for cannabis users and matched them to non-users in a 1:1 ratio (104,936:104,936). We then estimated the adjusted relative risk (aRR) for having CDI using conditional Possion regression models with generalized estimating equations [SAS 9.4]. RESULTS/ANTICIPATED RESULTS: Among the matched hospitalizations (n=209,872), cannabis usage was associated with a reduced incidence of CDI (505.8[464.7-550.6] vs. 694.9[645.8-747.70] per 100,000 hospitalizations), resulting in a 27% reduced risk of CDI (aRR:0.73[0.65-0.81]; p-value:<0.0001). Non-dependent and dependent cannabis users respectively had 22% and 78% reduced likelihood of CDI when compared to non-cannabis users (0.78[0.69-0.90] & 0.22[0.12-0.40]). Furthermore, dependent users had less risk of CDI compared to non-dependent users (0.28[0.16-0.51]). Comparatively, abusive use of other substances like alcohol and tobacco was associated with increased risk for CDI (1.30[1.13-1.49] & 1.24[1.10-1.40]) DISCUSSION/SIGNIFICANCE OF IMPACT: Unlike alcohol and tobacco abuse which are associated with elevated risk for CDI, cannabis use, is related to a decreased risk of CDI amongst hospitalized patients. Further prospective and molecular mechanistic studies are required to elucidate how cannabis impacts CDI.

scholarly journals 1110. A multicenter Evaluation of Outcomes Associated With Oral Vancomycin Dose in Patients With Clostridium difficile Infection

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S333-S333
Author(s):  
Monique Bidell ◽  
Gregory Novak ◽  
Gurkirat Singh ◽  
Benjamin Bratek ◽  
Odirichukwu Duru ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Standard Dose ◽  
Univariate Analysis ◽  
Fecal Microbiota ◽  
P Value ◽  
High Dose ◽  
Oral Vancomycin ◽  
Symptomatic Infection ◽  
Fecal Microbiota Transplant

Abstract Background Clostridium difficile infection (CDI) is a significant cause of morbidity and mortality. IDSA guidelines recommend oral vancomycin (VAN) for the treatment of CDI, although doses used in practice vary substantially. The purpose of this study was to determine differences in outcomes between patients treated with high dose (HD; ≥250 mg four times daily [QID]) vs. standard dose (SD; 125 mg QID) VAN for CDI. Methods This multicenter study evaluated patients at two hospitals in Albany, NY diagnosed with CDI and treated with oral VAN between January 2013 and August 2017. Hospitalized patients were included if: age ≥18 years, positive C. difficile toxin polymerase chain reaction (PCR), symptomatic infection (e.g., new onset or increased frequency of loose stools), and received ≥48 hours of VAN QID. Patients were excluded if: received ≥48 hours of metronidazole prior to VAN initiation, VAN per rectum, required surgical intervention ≤48 hours from PCR, had a history of fecal microbiota transplant, received ≥1 dose of fidaxomicin or tigecycline prior to or within 48 hours from PCR, or died ≤48 hours from PCR. The primary outcome was 90-day CDI recurrence; secondary outcomes included 30-day all-cause mortality and 90-day readmission. Variables with a P-value &lt;0.2 in univariate analysis were evaluated in multivariate (MV) analyses. Results Four hundred fifty-eight patients were included (site 1: 270; site 2: 188). Two hundred twenty-four patients received SD VAN (48.9%); 234 received HD VAN [250 mg QID: 199 (43.5%); 500 mg QID: 35 (7.6%)]. Baseline demographics were similar between groups. Patients treated with HD were more likely to present with colitis (19.2 vs. 29.5%, P = 0.01) and have higher infection severity based on IDSA (P &lt; 0.01), Zar (P &lt; 0.01), and American College of Gastroenterology (P &lt; 0.02) criteria. Modified APACHE II scores were similar between SD and HD groups (median: 12.2 vs. 12.9, P = 0.17). MV analysis identified no difference in 90-day recurrence with HD (OR 1.65, P = 0.13) after controlling for solid tumor cancers, immunosuppression, and IDSA severity. Similarly, no significant differences between SD and HD were observed for 30-day mortality and 90-day readmission. Conclusion No differences in recurrence, mortality, or readmission were identified between SD and HD oral VAN for the treatment of CDI, though HD VAN patients primarily received 250 mg QID. Disclosures All authors: No reported disclosures.

Relationship Between Remote History of Cholecystectomy and Risk for Incident Clostridium difficile Infection

2018 ◽  
Vol 113 (Supplement) ◽  
pp. S94-S95
Author(s):  
Ying Wang ◽  
Jianhua Li ◽  
Philip Zachariah ◽  
Julian Abrams ◽  
Daniel E. Freedberg
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
History Of
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