ASPECTS OF COMMUNITARY-ACQUIRED CLOSTRIDIUM DIFFICILE INFECTION IN DOLJ COUNTY, ROMÂNIA

Long regarded as a hospital-associated and antibiotic use infection, Clostridium difficile infection (CDI) has seen an increasing incidence as a community-aquired infection over the last decade. Objectives. The paper follows the particularities of CDI with a community onset, depending on the community or nosocomial origin of the infection. Material and method. Three-year retrospective study (July 1, 2014 – June 30, 2017) of 767 confirmed cases with primary CDI, hospitalized in medical units in Dolj county (România). Two groups of patients with community-onset CDI were analyzed: CA-CDI group with community origin of the infection, and NA-CDIc group with nosocomial origin. Results. CDI with community onset was identified in 453 patients (59.1% of the total); of these, 106 (23.4%) had community origin (CA-CDI) and 305 (67.3%) nosocomial (NA-CDIc). CA-CDI has increased from 4.3% (2014) to 17.9% (2017) of the total CDI, with an average of 13.1% for the study period. Compared to hospital acquired CDI, patients with community-acquired infection were younger (median age 57 years vs 65 years), more frequently women (58.4% vs 46.2%), with lower exposure to antibiotics (75.4% vs 85.9%), lower associated immunodepression (4.7% vs 18.6%) and mortality (0.9% vs. 5.5%). Conclusions. CDI epidemiology is dynamic, the actual size of community infection requiring further assessment. CA-CDI should be considered in the investigation of community diarrhea, even in the absence of traditional risk factors (hospitalization, advanced age, antibiotic treatment).

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Toxic megacolon complicating a Clostridium difficile infection in a pregnant woman

Journal of Medical Microbiology ◽

10.1099/jmm.0.012526-0 ◽

2010 ◽

Vol 59 (1) ◽

pp. 124-126 ◽

Cited By ~ 6

Author(s):

Alberto Candiotto ◽

Irene Pascoli ◽

Alessandra Gritti ◽

Enrico Busato ◽

Giuseppe Dal Pozzo

Keyword(s):

Risk Factors ◽

Pregnant Woman ◽

Clostridium Difficile ◽

Clostridium Difficile Infection ◽

Toxic Megacolon ◽

Antibiotic Use ◽

Hospitalized Patients ◽

Second Trimester ◽

Traditional Risk Factors

Clostridium difficile infection (CDI) in non-hospitalized patients has been reported with increased frequency, whereas an association between CDI and pregnancy has not been highlighted. We report a case of toxic megacolon complicating a severe CDI during the second trimester of pregnancy in a patient without traditional risk factors, such as antibiotic use, immunodeficiency, and prolonged and recent hospitalization.

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

Serbian Journal of Experimental and Clinical Research ◽

10.1515/sjecr-2016-0032 ◽

2016 ◽

Vol 17 (2) ◽

pp. 139-144

Author(s):

Ivana Raković ◽

Biljana Popovska Jovicic ◽

Andriana Bukonjic ◽

Sara Petrovic ◽

Petar Canovic ◽

...

Keyword(s):

Risk Factors ◽

Clostridium Difficile ◽

Clostridium Difficile Infection ◽

Antibiotic Use ◽

Demographic Characteristics ◽

Medical Documentation ◽

Hospital Treatment ◽

Continuous Variables ◽

Bacterial Strains ◽

H2 Blockers

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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Clostridium difficile in Inflammatory Bowel Disease: A Retrospective Study

Gastroenterology Research and Practice ◽

10.1155/2017/4803262 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

William Gillespie ◽

Neil Marya ◽

Julien Fahed ◽

Gregory Leslie ◽

Krunal Patel ◽

...

Keyword(s):

Risk Factors ◽

Inflammatory Bowel Disease ◽

Retrospective Study ◽

Clostridium Difficile ◽

Bowel Disease ◽

Biologic Therapy ◽

Antibiotic Use ◽

Extraintestinal Manifestations ◽

Chi Squared ◽

Inflammatory Bowel

Aim. To investigate the epidemiology and risk factors of Clostridium difficile infections (CDI) in patients with inflammatory bowel disease (IBD). Methods. This is a retrospective study of patients diagnosed with IBD. 1006 charts were screened and 654 patients met the inclusion criteria. Patients were divided into 2 cohorts based on the presence of prior diagnosis of CDI. Statistical analysis with Pearson’s chi-squared and two-sample t-test was performed. Results. The incidence of CDI among IBD patients was 6.7%. There was equal prevalence of CDI among Crohn’s disease (CD) (n=21, 49%) and ulcerative colitis (UC) (n=22, 51%). IBD patients acquired CDI at a mean age of 42.7 years, with 56% of infections acquired in the community and only 28% associated with healthcare. Only 30% of IBD patients with CDI had prior antibiotic use, and 16% had prior steroid use. IBD patients were significantly more likely to require biologic therapy (57% versus 37%, p<0.01) and have extraintestinal manifestations of IBD (43% versus 28%, p<0.02). Conclusions. IBD patients are more susceptible to CDI at a younger age and often lack traditional risk factors. IBD patients with at least one CDI were more likely to require biologic therapy and had greater rates of extraintestinal manifestations.

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