Outcomes of Clostridioides difficile infection in adult cancer and non-cancer patients hospitalised in a tertiary hospital: a prospective cohort study.

BACKGROUND: Clostridioides difficile infection (CDI) is one of the most common healthcare-associated (HA) infections. Cancer patients, particularly haemato-oncological patients, have an increased risk for CDI due to more risk factors compared with non-cancer patients. The aim of this study was to investigate differences in outcomes associated with HA CDI in patients with solid and haematological malignancies compared with patients with no underlying malignant disease in a tertiary healthcare centre in Serbia. METHODS: A prospective cohort study was conducted including adult patients diagnosed with an initial episode of HA CDI. Their demographic and clinical characteristics associated with risk factors for CDI were documented. Outcomes such as all-cause 30-day mortality, cure of infection, diarrhoea relaps and recurrence of disease were followed. Patients were assigned to cancer and non-cancer groups. Within the cancer group, patients were divided into the solid tumour subgroup and haematological malignancy subgroup. RESULTS: During a 7-year period, HA CDI was observed in 28 (5.1%) patients with haematological malignancy, 101 (18.3%) patients with solid tumours and 424 (76.7%) non-cancer patients. Older age (OR 1.04, 95% CI 1.02 to 1.07, p<0.001), admission to the intensive care unit (ICU) (OR 2.61, 95% CI 1.37 to 4.95, p=0.003), mechanical ventilation (OR 5.19, 95% CI 2.78 to 9.71, p<0.001) and use of antibiotics prior to CDI (OR 1.04, 95% CI 1.02 to 1.06, p=0.02) were associated with increased mortality. Compared with patients with solid tumours, patients with haematological malignancy were younger (65 vs 57 years, p=0.015), did not require ICU admission (25.0% vs 0%) or mechanical ventilation (8.9% vs 0%) and were treated longer with antibiotics prior to CDI (14 vs 24 days, p=0.002). CONCLUSIONS: Patients with haematological malignancy were exposed to different risk factors for CDI associated with mortality compared with patients with solid tumours and non-cancer patients. Older age, ICU stay and mechanical ventilation, but not presence or type of cancer, predicted the all-cause 30-day mortality.

Acquisition of /s/ clusters in Croatian speaking children with phonological disorders.

The authors studied the acquisition of nine #sC clusters in 30 Croatian-speaking phonologically disordered children, aged between 3;8-7;0 years, by analysing their renditions of target words elicited in response to visual stimuli presented on a computer screen. Results did not support the idea that a greater jump in sonority from C1 to C2 would translate into a greater accuracy of productions. The percentage of correct realizations was high for /s/+nasal combinations (mean 85%), and for approximants /j/ and // (mean 77%) and stops (mean 73%), with significantly lower scores for liquids /l/ and /r/ (mean 47%). The difference between SSP-violating and SSP-following targets was not significant, and neither was the homorganicity of the target. The most frequent errors were substitution of the first consonant (i.e. /s/) while keeping the second one. These children are significantly different from the typically-developing group in two ways. First, retention of the first or the second consonant is not as frequent, and, second, /l/ is almost as difficult as /r/, as opposed to the typically-developing children who had no more difficulty with /l/ than with the other two approximants. Although cluster reduction is not the most common process in erroneous productions, the patterns emerged here generally agree with the findings from other languages.

Schizophyllum commune associated with bronchogenous cyst.

Previous TBC lesions, diabetes and use of corticosteroids are recognised as risk factors for developing long-standing disease caused by Schizophyllum commune. In the case report presented in this work, S. commune was isolated from an inflamed bronchogenous cyst of previously immunocompetent patient. The isolated mould failed to sporulate and identification was achieved by nucleotide sequencing.