Mortality Following Clostridioides difficile Infection in Europe : A Retrospective Multicenter Case-Control Study
Czepiel, Jacek (Department of Infectious and Tropical Diseases, Jagiellonian University Medical College)
Krutova, Marcela (ESCMID Study Group for Clostridioides Difficile (ESGCD))
Mizrahi, Assaf (Institut Micalis UMR 1319, Université Paris-Saclay, INRAe, AgroParisTech)
Khanafer, Nagham (Centre International de Recherche en Infectiologie (CIRI), Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Université de Lyon)
Enoch, David A. (Addenbrookes Hospital (Cambridge, Regne Unit))
Patyi, Márta (Hygienic Department, Bács-Kiskun County Teaching Hospital)
Deptuła, Aleksander (Department of Propaedeutics of Medicine and Infection Prevention, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University)
Agodi, Antonella (Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania)
Nuvials, Xavier (Hospital Universitari Vall d'Hebron)
Pituch, Hanna (Department of Medical Microbiology, Medical University of Warsaw)
Wójcik-Bugajska, Małgorzata (Department of Internal and Geriatric Diseases, Jagiellonian University Medical College)
Filipczak-Bryniarska, Iwona (Department of Pain Treatment and Palliative Care, Jagiellonian University Medical College)
Brzozowski, Bartosz (Department of Gastroenterology and Hepatology, Jagiellonian University Medical College)
Krzanowski, Marcin (Department of Nephrology and Dialysis Unit, Jagiellonian University Medical College)
Konturek, Katarzyna (Intensive Care Unit, University Hospital)
Fedewicz, Marcin (Józef Babiński Hospital)
Michalak, Mateusz (Ludwik Rydygier Hospital)
Monpierre, Lorra (Service de Microbiologie Clinique, Groupe Hospitalier Paris Saint-Joseph)
Vanhems, Philippe (Centre International de Recherche en Infectiologie (CIRI), Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Université de Lyon)
Gouliouris, Theodore (Addenbrookes Hospital (Cambridge, Regne Unit))
Jurczyszyn, Artur (Department of Hematology, Jagiellonian University Medical College)
Goldman-Mazur, Sarah (Department of Hematology, Jagiellonian University Medical College)
Wultańska, Dorota (Department of Medical Microbiology, Medical University of Warsaw)
Kuijper, Ed J. (Rijksinstituut voor Volksgezondheid en Milieu)
Skupień, Jan (Department of Metabolic Diseases, Jagiellonian University Medical College, 30-688 Krakow, Poland)
Biesiada, Grażyna (Department of Infectious and Tropical Diseases, Jagiellonian University Medical College)
Garlicki, Aleksander (Department of Infectious and Tropical Diseases, Jagiellonian University Medical College)
Universitat Autònoma de Barcelona

Date:	2021
Abstract:	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 β-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.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Clostridioides difficile infection ; Co-morbidities ; Mortality ; Malignancy ; Outcome ; Risk factors
Published in:	Antibiotics, Vol. 10 (march 2021) , ISSN 2079-6382

DOI: 10.3390/antibiotics10030299
PMID: 33805755

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