Hospital-acquired Clostridium difficile-associated disease in the intensive care unit setting: epidemiology, clinical course and outcome.
BMC Infect Dis
; 7: 42, 2007 May 21.
Article
em En
| MEDLINE
| ID: mdl-17517130
ABSTRACT
BACKGROUND:
Clostridium difficile-associated disease (CDAD) is a serious nosocomial infection, however few studies have assessed CDAD outcome in the intensive care unit (ICU). We evaluated the epidemiology, clinical course and outcome of hospital-acquired CDAD in the critical care setting.METHODS:
We performed a historical cohort study on 58 adults with a positive C. difficile cytotoxin assay result occurring in intensive care units.RESULTS:
Sixty-two percent of patients had concurrent infections, 50% of which were bloodstream infections. The most frequently prescribed antimicrobials prior to CDAD were anti-anaerobic agents (60.3%). Septic shock occurred in 32.8% of CDAD patients. The in-hospital mortality was 27.6%. Univariate analysis revealed that SOFA score, at least one organ failure and age were predictors of mortality. Charlson score >/=3, gender, concurrent infection, and number of days with diarrhea before a positive C. difficile toxin assay were not significant predictors of mortality on univariate analysis. Independent predictors for death were SOFA score at infection onset (per 1-point increment, OR 1.40; CI95 1.13-1.75) and age (per 1-year increment, OR 1.10; CI95 1.02-1.19).CONCLUSION:
In ICU patients with CDAD, advanced age and increased severity of illness at the onset of infection, as measured by the SOFA score, are independent predictors of death.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Enterocolite Pseudomembranosa
/
Infecção Hospitalar
/
Clostridioides difficile
Idioma:
En
Ano de publicação:
2007
Tipo de documento:
Article