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 / Granata, Guido; Petrosillo, Nicola; Adamoli, Lucia; Bartoletti, Michele; Bartoloni, Alessandro; Basile, Gregorio; Bassetti, Matteo; Bonfanti, Paolo; Borromeo, Raffaella; Ceccarelli, Giancarlo; De Luca, Anna Maria; Di Bella, Stefano; Fossati, Sara; Franceschini, Erica; Gentile, Ivan; Giacobbe, Daniele Roberto; Giacometti, Enrica; Ingrassia, Fabrizio; Lagi, Filippo; Lobreglio, Giambattista; Lombardi, Andrea; Lupo, Laura Isabella; Luzzati, Roberto; Maraolo, Alberto Enrico; Mikulska, Malgorzata; Mondelli, Mario Umberto; Mularoni, Alessandra; Mussini, Cristina; Oliva, Alessandra; Pandolfo, Alessandro; Rogati, Carlotta; Trapani, Filippo Fabio; Venditti, Mario; Viale, Pierluigi; Caraffa, Emanuela; Cataldo, Maria Adriana; On Behalf Of The ReCloDi Recurrence Of Clostridioides Difficile Infection Study Group, Null. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 10:5(2021), pp. 1-11. [10.3390/jcm10051127]
Prospective study on incidence, risk factors and outcome of recurrent clostridioides difficile infections
Granata, Guido;Ceccarelli, Giancarlo;De Luca, Anna Maria;Lombardi, Andrea;Oliva, Alessandra;Venditti, Mario;Caraffa, Emanuela;
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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
