00f2e421a1263e5abaf92b2e5fc7f086 pmc_33805755.pdf e491130ac168789baefaa6e10ce2e9eb0a89947c pmc_33805755.pdf c78a9a0f751e1dbb40d4d47b804f681d8137871d2110889121fafc30834cf6b5 pmc_33805755.pdf Title: Mortality Following Clostridioides difficile Infection in Europe: A Retrospective Multicenter Case-Control Study Subject: We aimed to describe the clinical presentation, treatment, outcome and report on factors associated with mortality over a 90-day period in Clostridioides difficile infection (CDI). Descriptive, univariate, and multivariate regression analyses were performed on data collected in a retrospective case-control study conducted in nine hospitals from seven European countries. A total of 624 patients were included, of which 415 were deceased (cases) and 209 were still alive 90 days after a CDI diagnosis (controls). The most common antibiotics used previously in both groups were -lactams; previous exposure to fluoroquinolones was significantly (p = 0.0004) greater in deceased patients. Multivariate logistic regression showed that the factors independently related with death during CDI were older age, inadequate CDI therapy, cachexia, malignancy, Charlson Index, long-term care, elevated white blood cell count (WBC), C-reactive protein (CRP), bacteraemia, complications, and cognitive impairment. In addition, older age, higher levels of WBC, neutrophil, CRP or creatinine, the presence of malignancy, cognitive impairment, and complications were strongly correlated with shortening the time from CDI diagnosis to death. CDI prevention should be primarily focused on hospitalised elderly people receiving antibiotics. WBC, neutrophil count, CRP, creatinine, albumin and lactate levels should be tested in every hospitalised patient treated for CDI to assess the risk of a fatal outcome. Keywords: Clostridioides difficile infection; co–morbidities; mortality; malignancy; outcome; risk factors Author: Jacek Czepiel, Marcela Krutova, Assaf Mizrahi, Nagham Khanafer, David A. Enoch, Márta Patyi, Aleksander Deptuła, Antonella Agodi, Xavier Nuvials, Hanna Pituch, Małgorzata Wójcik-Bugajska, Iwona Filipczak-Bryniarska, Bartosz Brzozowski, Marcin Krzanowski, Katarzyna Konturek, Marcin Fedewicz, Mateusz Michalak, Lorra Monpierre, Philippe Vanhems, Theodore Gouliouris, Artur Jurczyszyn, Sarah Goldman-Mazur, Dorota Wultańska, Ed J. Kuijper, Jan Skupień, Grażyna Biesiada and Aleksander Garlicki Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Sat Mar 13 11:09:01 2021 CET ModDate: Sat Mar 13 11:16:39 2021 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 11 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 313296 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- HZCUWH+VnURWPalladioL Type 1 Custom yes yes no 10 0 NKSFWY+URWPalladioL-Ital Type 1 Custom yes yes no 15 0 NFPSJQ+URWPalladioL-Bold Type 1 Custom yes yes no 20 0 EEYNML+URWPalladioL-BoldItal Type 1 Custom yes yes no 24 0 WLHNBW+URWPalladioL-Roma Type 1 Custom yes yes no 28 0 ENXZUH+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 YYFPCJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 41 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 63 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 67 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 71 0 QWWHCD+EURM10 Type 1 Builtin yes yes no 83 0 OHXQCJ+CMSY10 Type 1 Builtin yes yes no 93 0 KFAQUP+EURB10 Type 1 Builtin yes yes no 103 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-10-02 03:24:44 CEST RepresentationInformation: pmc_33805755.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2023-03-31 12:09:31 CEST Size: 313296 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 299 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Population Destination: subsection.2.1 Item: Title: Data Collection Destination: subsection.2.2 Item: Title: Definitions Destination: subsection.2.3 Item: Title: Statistical Analysis Destination: subsection.2.4 Item: Title: Results Destination: section.3 Children: Item: Title: Descriptive Analysis of Included Patients Destination: subsection.3.1 Item: Title: The Clinical Course of CDI Destination: subsection.3.2 Item: Title: Predictors of Death in CDI Destination: subsection.3.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.5 Info: Title: Mortality Following Clostridioides difficile Infection in Europe: A Retrospective Multicenter Case-Control Study Author: おちっづに〠ぃぺづばどづぬ〬〠きちひっづぬち〠かひふぴはぶち〬〠ぁびびちて〠きどぺひちとど〬〠ぎちでとちね〠かとちのちてづひ〬〠いちぶどつ〠ぁ〮〠ぅのはっと〬〠きメひぴち〠ぐちぴべど〬〠ぁぬづにびちのつづひ〠いづばぴふㅂち〬〠ぁのぴはのづぬぬち〠ぁではつど〬〠じちぶどづひ〠ぎふぶどちぬび〬〠えちののち〠ぐどぴふっと〬〠きちㅂではひぺちぴち〠しンなっどに〭あふでちなびにち〬〠ぉぷはのち〠うどぬどばっぺちに〭あひべのどちひびにち〬〠あちひぴはびぺ〠あひぺはぺはぷびにど〬〠きちひっどの〠かひぺちのはぷびにど〬〠かちぴちひぺべのち〠かはのぴふひづに〬〠きちひっどの〠うづつづぷどっぺ〬〠きちぴづふびぺ〠きどっとちぬちに〬〠がはひひち〠きはのばどづひひづ〬〠ぐとどぬどばばづ〠ざちのとづねび〬〠ごとづはつはひづ〠ぇはふぬどはふひどび〬〠ぁひぴふひ〠おふひっぺべびぺべの〬〠こちひちと〠ぇはぬつねちの〭きちぺふひ〬〠いはひはぴち〠しふぬぴちㅄびにち〬〠ぅつ〠お〮〠かふどなばづひ〬〠おちの〠こにふばどづㅄ〬〠ぇひちㅼべのち〠あどづびどちつち〠ちのつ〠ぁぬづにびちのつづひ〠ぇちひぬどっにど Subject: We aimed to describe the clinical presentation, treatment, outcome and report on factors associated with mortality over a 90-day period in Clostridioides difficile infection (CDI). Descriptive, univariate, and multivariate regression analyses were performed on data collected in a retrospective case-control study conducted in nine hospitals from seven European countries. A total of 624 patients were included, of which 415 were deceased (cases) and 209 were still alive 90 days after a CDI diagnosis (controls). The most common antibiotics used previously in both groups were -lactams; previous exposure to fluoroquinolones was significantly (p = 0.0004) greater in deceased patients. Multivariate logistic regression showed that the factors independently related with death during CDI were older age, inadequate CDI therapy, cachexia, malignancy, Charlson Index, long-term care, elevated white blood cell count (WBC), C-reactive protein (CRP), bacteraemia, complications, and cognitive impairment. In addition, older age, higher levels of WBC, neutrophil, CRP or creatinine, the presence of malignancy, cognitive impairment, and complications were strongly correlated with shortening the time from CDI diagnosis to death. CDI prevention should be primarily focused on hospitalised elderly people receiving antibiotics. WBC, neutrophil count, CRP, creatinine, albumin and lactate levels should be tested in every hospitalised patient treated for CDI to assess the risk of a fatal outcome. 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