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.

Prospective Study on Incidence, Risk Factors and Outcome of Recurrent Clostridioides difficile Infections / G. Granata, N. Petrosillo, L. Adamoli, M. Bartoletti, A. Bartoloni, G. Basile, M. Bassetti, P. Bonfanti, R. Borromeo, G. Ceccarelli, A.M. De Luca, S. Di Bella, S. Fossati, E. Franceschini, I. Gentile, D.R. Giacobbe, E. Giacometti, F. Ingrassia, F. Lagi, G. Lobreglio, A. Lombardi, L.I. Lupo, R. Luzzati, A.E. Maraolo, M. Mikulska, M.U. Mondelli, A. Mularoni, C. Mussini, A. Oliva, A. Pandolfo, C. Rogati, F.F. Trapani, M. Venditti, P. Viale, E. Caraffa, M.A. Cataldo. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 10:5(2021), pp. 1127.1-1127.11. [10.3390/JCM10051127]

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

Bonfanti, Paolo;Giacobbe, Daniele Roberto;Lombardi, Andrea;Pandolfo, Alessandro;
2021

Abstract

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.
Clostridioides difficile; recurrence; risk factors; outcome; incidence
Settore MED/17 - Malattie Infettive
Dipartimenti di Eccellenza 2018-2022 - Dipartimento di FILOSOFIA
JOURNAL OF CLINICAL MEDICINE
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/849636
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