Clinical outcomes of Clostridium difficile infection according to strain type. A prospective study in medical wards.
Eur J Intern Med
; 54: 21-26, 2018 08.
Article
em En
| MEDLINE
| ID: mdl-29650357
ABSTRACT
OBJECTIVES:
To describe clinical characteristics and outcome of Clostridium difficile infection (CDI) patients in Internal Medicine, to identify ribotypes (RTs); to evaluate the association between RT and patient clinical characteristics and report outcome.METHODS:
One year prospective cohort study. Clinical data, Barthel Index (BI) and outcomes were collected for all inpatients suffering from CDI (nâ¯=â¯148) in hospital wards in Northern Italy. 84 fecal samples were analysed for molecular typing.RESULTS:
12 RTs were identified, predominantly RT018 (42.9%, nâ¯=â¯36/84) and RT356/607 (40.5%, nâ¯=â¯34/84). Patients with dementia were more frequent among those infected by RT018 [55.6% (nâ¯=â¯20/36) vs. 32.4% (nâ¯=â¯11/34), pâ¯=â¯0.05]. The median BI score of patients with RT018 was lower than BI score of patients with RT356/607 [10 (IQR 0-32) vs. 15 (IQR 5-50), pâ¯=â¯0.06]. RT018 infection was associated to higher levels of C-reactive protein [7.2â¯mg/dl (IQR 4.1-14.7) vs. 4.0â¯mg/dl (IQR 2.2-6.8), pâ¯=â¯0.01] and white blood cells ≥15,000/dl [33.3% (nâ¯=â¯12/36) vs. 14.7% (nâ¯=â¯5/34) of patients, pâ¯=â¯0.07]. Higher mortality was noted among RT018 infected patients. We found a continuous mortality increase according to the ATLAS score.CONCLUSIONS:
Our results confirm that RT018 and RT356/607 are the two major RTs causing CDI in older patients with a high degree of disability in Northern Italy and RT018 is associated with more serious outcomes.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article