scholarly journals Incidence and risk factors of a severe Clostridium difficile infection: results of a retrospective cohort study at a tertiary care hospital

2019 ◽  
Author(s):  
Claas Baier ◽  
Simone Valentin ◽  
Frank Schwab ◽  
Sandra Steffens ◽  
Ralf-Peter Vonberg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Tertiary Care ◽  
Care Hospital ◽  
Care Clinic ◽  
Independent Risk Factors

Abstract Background Clostridium difficile infection (CDI) is a relevant healthcare burden worldwide and one of the leading causes for nosocomial diarrhea. Besides mild courses, the development of a severe infection can occur and has a relevant impact on healthcare costs and patient outcome.Methods We conducted a retrospective cohort study over a 4 year-long period to analyze the incidence of CDI and the contributing risk factors for a severe course at a tertiary care clinic. Independent risk factors were determined by a multivariable logistic regression analysis.Results A total of 761 CDI cases were identified in the study period, thereof 612 (80.4%) cases were nosocomially acquired. The mean incidence for a CDI was 0.42 cases per 1000 patient-days. A severe CDI occurred in 131 cases (17.2%). Independent risk factors for a severe course were pulmonary disease, a Charlson comorbidity index >3, and a preceding antibiotic therapy within three months with glycopeptides (vancomycin/teicoplanin) and/or aminoglycosides.Conclusions This study highlights the relevant burden of CDI in hospitals. Moreover, it underscores that specific knowledge of risk factors contributing to severe CDI is crucial to optimize treatment, infection prevention measures and to guide clinical monitoring and therapy strategy.

scholarly journals Clinical characteristics and factors related to antibiotic-associated diarrhea in elderly patients with pneumonia: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yoko Takedani ◽  
Tsukasa Nakamura ◽  
Noriko Fukiwake ◽  
Toshihiro Imada ◽  
Junji Mashino ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Elderly Patients ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Tertiary Care ◽  
Multivariate Logistic Regression Model ◽  
Care Hospital ◽  
Antibiotic Associated Diarrhea ◽  
Elderly Inpatients

Abstract Background Antibiotic-associated diarrhea (AAD) is a common problem among elderly inpatients because many elderly patients are admitted for pneumonia or other conditions that necessitate antibiotic treatment. In the super aging population, more patients are suffering from pneumonia than before, but the incidence or risk factors for AAD among many elderly patients have not been well scrutinized. Methods We conducted a retrospective cohort study of elderly patients diagnosed with pneumonia from April 2014 to March 2019 who were admitted to the Department of General Medicine of a Tertiary Care Hospital in Japan. Patients (≥ 65 years of age) who were diagnosed with bacterial pneumonia or aspiration pneumonia and treated with antibiotics were included. We defined AAD by diarrhea with more than three loose or watery stools per day and included patients who had these symptoms for either one day or two or more consecutive days. We also assessed the length of hospital stay and in-hospital mortality. The potential risk factors for AAD included age, sex, body weight, body mass index, smoking, alcohol, activities of daily living (ADL),　comorbidities, vital signs, laboratories, the severity of pneumonia, antibiotic and other medication use. Results There were 1,067 patients, the mean age was 83 years, and men accounted for 59 %. β-Lactamase inhibitors were frequently prescribed antibiotics in 703 patients (66 %), and proton pump inhibitors (PPIs) were also commonly administered (48 %). AAD developed in 322 patients (30 %). The multivariate logistic regression model showed that β-lactamase inhibitors (OR 1.43, 95 % CI 1.05–1.95) and PPIs (OR 1.37, 95 % CI 1.03–1.83) were associated with AAD as well as age (OR 1.03 per year, 95 % CI 1.01–1.05). Conclusions AAD was common among elderly inpatients with pneumonia, and β-lactamase inhibitors and PPIs were associated with AAD. Strict use of such medication should be considered to decrease the risk of AAD.

scholarly journals 491. Clinical Manifestations and Outcomes of Clostridium difficile Infection in Long-Term Care Patients: An 8-Year Retrospective Cohort Study

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S182-S182
Author(s):  
Suganya Chandramohan ◽  
Amar Krishna ◽  
Parminder Virdi ◽  
Jordon Polistico ◽  
Nikhila Thammineni ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Long Term Care ◽  
Clinical Manifestations ◽  
Term Care

scholarly journals Predictors of Infliximab Refractory Intestinal Behçet’s Syndrome: A Retrospective Cohort Study from the Shanghai Behçet’s Syndrome Database

2021 ◽  
Author(s):  
Hua-fang Bao ◽  
Cheng-cheng Hou ◽  
Bo Ye ◽  
Jun Zou ◽  
Dan Luo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Protective Factor ◽  
Behçet’S Syndrome ◽  
Behçet's Syndrome ◽  
Behcet’S Syndrome ◽  
Independent Risk Factors ◽  
Behcet's Syndrome

ABSTRACT Objectives This retrospective cohort study aimed to find out predictors and early biomarkers of Infliximab (IFX) refractory Intestinal Behçet’s Syndrome (intestinal BS). Methods We collected the baseline clinical characteristics, laboratory parameters and concomitant therapies of intestinal BS patients treated by IFX from the Shanghai Behçet’s syndrome database. After 1-year IFX therapy, intestinal BS patients with non-mucosal healing (NMH, intestinal ulcers detected by colonoscopy) and/or no clinical remission [NCR, scores of the disease activity index for intestinal Behçet’s disease (DAIBD) ≥ 20] was defined as IFX refractory intestinal BS. Multivariate logistic regression analysis was performed to evaluate the predictors for NMH and NCR in IFX refractory intestinal BS. Results In 85 intestinal BS patients, NMH was identified in 29 (34.12%) patients, and NCR was confirmed in 20 (23.53%) patients. ESR (≥ 24mm/h) and fT3 (≤ 3.3pmol/L) were the independent risk factors of NMH in IFX refractory intestinal BS. Drinking alcohol and the fT3/fT4 ratio (≤ 0.24) were independent risk factors, and thalidomide was an independent protective factor, for NCR in intestinal BS patients treated by IFX. Conclusion This study may be applicable for adjusting the therapeutic strategy and sidestepping unnecessary exposure to IFX in intestinal BS patients. Routine assessments of ESR, fT3 and fT3/fT4 ratio are helpful to identify high-risk individuals of IFX refractory intestinal BS. Thalidomide is suggested to be a concomitant therapy with IFX for intestinal BS patients.

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