scholarly journals Clinical characterization and risk factors of Clostridium difficile infection in elderly patients in a Chinese hospital

2015 ◽  
Vol 9 (04) ◽  
pp. 381-387 ◽  
Author(s):  
Zhang Lihua ◽  
Dong Danfeng ◽  
Jiang Cen ◽  
Wang Xuefeng ◽  
Peng Yibing
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Elderly Patients ◽  
Clinical Features ◽  
Clostridium Difficile Infection ◽  
Gastrointestinal Disease ◽  
Statistical Tests ◽  
The Elderly ◽  
Hospitalized Patients ◽  
Elderly Hospitalized Patients

Introduction: Clostridium difficile is a common cause of nosocomial diarrhea, especially in elderly patients. This study aimed to analyze the clinical features and assess the risk factors associated with Clostridium difficile infection (CDI) in elderly hospitalized patients. Methodology: A retrospective case-control study was conducted among elderly hospitalized patients (> 60 years of age) in a Chinese tertiary hospital between 2010 and 2013. Fifty-two CDI patients and 150 randomly selected non-CDI patients were included in the study. Clinical features of CDI and non-CDI patients were compared by appropriate statistical tests. Logistic regression analyses were performed on a series of factors to determine the risk factors for CDI among the elderly hospitalized patients. Results: The elderly CDI patients showed higher leukocyte counts, lower serum albumin levels, longer duration of hospital stay, and higher mortality compared to the non-CDI patients. The proportion of patients admitted to the intensive care unit or exposed to gastric acid suppressants was also significantly different (p < 0.05) between the two groups. Multivariate analysis indicated that serum creatinine (OR 1.004; 95% CI 1.001–1.008), surgical intervention (OR 6.132; 95% CI 2.594–14.493), the number of comorbidities (OR 2.573; 95% CI 1.353–4.892), gastrointestinal disease (OR 4.670; 95% CI 2.002–10.895), and antibiotic use (OR 6.718; 95% CI 2.846–15.859) were independently associated with CDI. Conclusions: This study revealed several risk factors for CDI among elderly hospitalized patients. These findings will increase the knowledge concerning this disease and provide information regarding the control and prevention of CDI in the elderly.

scholarly journals Risk factors and outcomes of Clostridium difficile infection in hospitalized patients

2019 ◽  
Vol 42 (2) ◽  
pp. 99-106 ◽  
Author(s):  
Hao-Yuan Lee ◽  
Hsuan-Ling Hsiao ◽  
Chin-Yuan Chia ◽  
Chun-Wen Cheng ◽  
Tzu-Cheng Tsai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Hospitalized Patients

scholarly journals Risk factors for Clostridium difficile infection in hospitalized patients with community-acquired pneumonia

2016 ◽  
Vol 73 (1) ◽  
pp. 45-53 ◽  
Author(s):  
James D. Chalmers ◽  
Ahsan R. Akram ◽  
Aran Singanayagam ◽  
Mark H. Wilcox ◽  
Adam T. Hill
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Community Acquired Pneumonia ◽  
Hospitalized Patients

scholarly journals Predictors associated with failure of metronidazole in treatment of clostridium difficile infection in the elderly

2014 ◽  
Vol 67 (suppl. 2) ◽  
pp. 18-23
Author(s):  
Nadica Kovacevic ◽  
Grozdana Canak ◽  
Tomislav Preveden ◽  
Slavica Tomic ◽  
Vedrana Petric ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Treatment Failure ◽  
Clostridium Difficile Infection ◽  
Clinical Symptoms ◽  
Concomitant Administration ◽  
The Elderly ◽  
Albumin Level ◽  
Nosocomial Diarrhea ◽  
Clinical Center

Introduction. Clostridium difficile is the most common infectious cause of nosocomial diarrhea. Recommended treatments for Clostridium difficile infection include metronidazole and vancomycin. Recent investigation has shown an increasing rate of metronidazole treatment failure, particularly among the elderly. The authors studied the outcome of metronidazole therapy for Clostridium difficile infection in patients over 65 years of age and risk factors associated with metronidazole treatment failure. Material and Methods. This retrospective study was performed at the Department of Infectious Diseases, Clinical Center of Vojvodina from January 2011 to January 2014. The study sample included 112 patients, over 65 years of age, diagnosed with Clostridium difficile infection, who were treated with oral metronidazole 400 mg 3 times per day for 10 days. The efficacy of treatment regimen was assessed by resolution of diarrhea and rates of recurrence within 60 days after completion of therapy Results. Metronidazole was administrated to 112 patients over 65 years of age. Treatment with metronidazole resulted in resolution of diarrhea in 78 patients (69.65%). After successful metronidazole treatment, clinical symptoms of Clostridium difficile infection recurred in 28 the patients (36.60%) . Risk factors for metronidazole treatment failure are duration of diarrhea before treatment, leucocytosis >15 000/mm3, albumin level ?25 g/l, serum creatinine level ?200 ?mol/l, increased C-reactive protein, and concomitant administration of antibiotic and immunosuppressives. Conclusion. Our data suggest that patients with predictors of metronidazole treatment failure may benefit from initial oral vancomycin therapy for Clostridium difficile infection.

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