Mortality Following Clostridioides difficile Infection in Europe: A Retrospective Multicenter Case-Control Study
2021
Czepiel, Jacek | Krutova, Marcela | Mizrahi, Assaf | Khanafer, Nagham | Enoch, David, A | Patyi, Márta | Deptuła, Aleksander | Agodi, Antonella | Nuvials, Xavier | Pituch, Hanna | Wójcik-Bugajska, Małgorzata | Filipczak-Bryniarska, Iwona | Brzozowski, Bartosz | Krzanowski, Marcin | Konturek, Katarzyna | Fedewicz, Marcin | Michalak, Mateusz | Monpierre, Lorra | Vanhems, Philippe | Gouliouris, Theodore | Jurczyszyn, Artur | Goldman-Mazur, Sarah | Wultańska, Dorota | Kuijper, Ed, J | Skupień, Jan | Biesiada, Grażyna | Garlicki, Aleksander | Uniwersytet Jagielloński w Krakowie = Jagiellonian University (UJ) | Charles University [Prague] (CU) | ESCMID Study Group for Clostridioides Difficile (ESGCD) | MICrobiologie de l'ALImentation au Service de la Santé (MICALIS) ; AgroParisTech-Université Paris-Saclay-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE) | Groupe Hospitalier Paris Saint-Joseph (hpsj) | Centre International de Recherche en Infectiologie (CIRI) ; École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL) ; Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS) | Hospices Civils de Lyon (HCL) | Addenbrooke's Hospital ; Cambridge University NHS Trust | Bács-Kiskun County Teaching Hospital | Nicolaus Copernicus University [Toruń] | University of Catania [Italy] | Vall d'Hebron University Hospital [Barcelona] | Medical University of Warsaw - Poland | University Hospital of Cracow/Szpital Uniwersytecki w Krakowie [Poland] (SUK) | Józef Babinski Hospital | Ludwik Rydygier Hospital | Leiden University Medical Center (LUMC) ; Universiteit Leiden = Leiden University | Rijksinstituut voor Volksgezondheid en Milieu (RIVM)
International audience
Show more [+] Less [-]English. 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, andcognitive 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 afatal outcome.
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