Prospective Study on Incidence, Risk Factors and Outcome of Recurrent Clostridioides difficile Infections

Journal of Clinical Medicine

on behalf of the ReCloDi (Recurrence of Clostridioides difficile Infection) Study Group¹  Cristina Mussini²  Carlotta Rogati²  Erica Franceschini²  Emanuela Caraffa³  Nicola Petrosillo³  Maria Adriana Cataldo³  Guido Granata³  Alessandro Bartoloni⁴  Gregorio Basile⁴  Filippo Lagi⁴  Matteo Bassetti⁵  Malgorzata Mikulska⁵  Daniele Roberto Giacobbe⁵  Paolo Bonfanti⁶  Pierluigi Viale⁷  Filippo Fabio Trapani⁷  Michele Bartoletti⁷  Mario Venditti⁸  Giancarlo Ceccarelli⁸  Alessandra Oliva⁸  Mario Umberto Mondelli⁹  Andrea Lombardi⁹  Fabrizio Ingrassia^1,10  Raffaella Borromeo^1,10  Enrica Giacometti^1,11  Roberto Luzzati^1,12  Stefano Di Bella^1,12  Sara Fossati^1,12  Lucia Adamoli^1,13  Alessandra Mularoni^1,13  Anna Maria De Luca^1,13  Alessandro Pandolfo^1,14  Alberto Enrico Maraolo^1,15  Ivan Gentile^1,15  Laura Isabella Lupo^1,16  Giambattista Lobreglio^1,16 

[1] ;Clinic of Infectious Diseases, University of Modena and Reggio Emilia, 41121 Modena, Italy;Clinical and Research Department for Infectious Diseases, National Institute for Infectious Diseases L. Spallanzani IRCCS, 00149 Rome, Italy;Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy;Department of Health Sciences (DISSAL), University of Genoa, 16126 Genoa, Italy;Department of Infectious Diseases, San Gerardo Hospital, Monza—University of Milano-Bicocca, 20126 Milan, Italy;Department of Medical and Surgical Sciences, “Alma Mater Studiorum”, University of Bologna, IRCCS S. Orsola Teaching Hospital, 40126 Bologna, Italy;Department of Public Health and Infectious Diseases, Sapienza University of Rome, Policlinico Umberto I, 00185 Rome, Italy;Division of Infectious Diseases and Immunology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy;Hospital of Crema, 26013 Crema, Italy;Infectious Diseases Clinic, Department of Medicine University of Udine and Azienda Sanitaria Universitaria Integrata di Udine, 33100 Udine, Italy;Infectious Diseases Department, Azienda Sanitaria Universitaria Integrata di Trieste, 34128 Trieste, Italy;Infectious Diseases ISMETT IRCCS, 90127 Palermo, Italy;Infectious Diseases, ASST Lecco Hospital, 23900 Lecco, Italy;Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80138 Naples, Italy;Vito Fazzi Hospital, 73100 Lecce, Italy;

关键词: Clostridioides difficile;    recurrence;    risk factors;    outcome;    incidence;   

DOI  :  10.3390/jcm10051127

来源: DOAJ

【 摘 要 】

Background: Limited and wide-ranging data are available on the recurrent Clostridioides difficile infection (rCDI) incidence rate. Methods: We performed a cohort study with the aim to assess the incidence of and risk factors for rCDI. Adult patients with a first CDI, hospitalized in 15 Italian hospitals, were prospectively included and followed-up for 30 d after the end of antimicrobial treatment for their first CDI. A case–control study was performed to identify risk factors associated with 30-day onset rCDI. Results: Three hundred nine patients with a first CDI were included in the study; 32% of the CDI episodes (99/309) were severe/complicated; complete follow-up was available for 288 patients (19 died during the first CDI episode, and 2 were lost during follow-up). At the end of the study, the crude all-cause mortality rate was 10.7% (33 deaths/309 patients). Two hundred seventy-one patients completed the follow-up; rCDI occurred in 21% of patients (56/271) with an incidence rate of 72/10,000 patient-days. Logistic regression analysis identified exposure to cephalosporin as an independent risk factor associated with rCDI (RR: 1.7; 95% CI: 1.1–2.7, p = 0.03). Conclusion: Our study confirms the relevance of rCDI in terms of morbidity and mortality and provides a reliable estimation of its incidence.

【 授权许可】

Unknown