Clinical characteristics associated with the severity of Clostridium [Clostridioides] difficile infection in a tertiary teaching hospital from Mexico
Background: Clostridium difficile infection (CDI) is a leading cause of healthcare-associated diarrhea worldwide. In this study, risk factors associated with the development of severe-complicated and recurrent outcomes in CDI patients in different age groups, including the non-elderly, were assessed...
| Autores principales: | , , , , , , , , , , |
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| Formato: | Artículo |
| Lenguaje: | inglés |
| Publicado: |
Elsevier
2021
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| Materias: | |
| Acceso en línea: | http://eprints.uanl.mx/22459/1/22459.pdf |
| _version_ | 1838551004282355712 |
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| author | Tijerina Rodríguez, Laura Esther Garza González, Elvira Martínez Meléndez, Adrián Morfín Otero, Rayo Camacho Ortiz, Adrián Gonzalez Diaz, Esteban E. Pérez Gómez, Héctor Raúl Villarreal Treviño, Licet Maldonado Garza, Héctor Jesús Esparza Ahumada, Sergio Rodríguez Noriega, Eduardo |
| author_facet | Tijerina Rodríguez, Laura Esther Garza González, Elvira Martínez Meléndez, Adrián Morfín Otero, Rayo Camacho Ortiz, Adrián Gonzalez Diaz, Esteban E. Pérez Gómez, Héctor Raúl Villarreal Treviño, Licet Maldonado Garza, Héctor Jesús Esparza Ahumada, Sergio Rodríguez Noriega, Eduardo |
| author_sort | Tijerina Rodríguez, Laura Esther |
| collection | Repositorio Institucional |
| description | Background: Clostridium difficile infection (CDI) is a leading cause of healthcare-associated diarrhea worldwide. In this study, risk factors associated with the development of severe-complicated and recurrent outcomes in CDI patients in different age groups, including the non-elderly, were assessed in a third-level hospital.
Methods: CDI cases were detected by clinical data and polymerase-chain-reaction (PCR). Clinical, demographic, epidemiological, and microbiological risk factors for CDI were evaluated.
Results: During the study period, 248 out of 805 patients with nosocomial diarrhea were diagnosed with CDI and the majority were severe-complicated cases (87.90%). Female
gender (OR 3.19, 95% CI 1.19e8.55, p ¼ 0.02) and lymphoma (OR 3.95, 95% CI 1.03e15.13, p ¼ 0.04) were risk factors for severe-complicated CDI. Mature adulthood (51e60 years) (OR
5.80, 95% CI 1.56e21.62, p ¼ 0.01), previous rifampicin use (OR 7.44, 95% CI 2.10e26.44, p ¼ 0.00), and neoplasm (solid malignant neoplasm or hematological malignancies) (OR 4.12, 95% CI 1.01e16.83, p ¼ 0.04) were risk factors for recurrent infection. Autoimmune disorders (OR 6.62, CI 95% 1.26e34.73, p ¼ 0.02), leukemia (OR 4.97, 95% CI 1.05e23.58, p ¼ 0.04), lymphoma (OR 3.79, 95% CI 1.03e12.07, p ¼ 0.04) and previous colistin treatment (OR 4.97, 95% CI 1.05e23.58, p ¼ 0.04) were risk factors for 30-day mortality.
Conclusion: Newly identified risk factors for recurrent CDI were rifampicin treatment and age between 51 and 60 years; colistin treatment was identified as a risk factor for 30-day mortality. Previously identified risk factors for severe-complicated CDI were confirmed, but with a major impact on non-elderly patients. |
| format | Article |
| id | eprints-22459 |
| institution | UANL |
| language | English |
| publishDate | 2021 |
| publisher | Elsevier |
| record_format | eprints |
| spelling | eprints-224592025-07-23T15:42:18Z http://eprints.uanl.mx/22459/ Clinical characteristics associated with the severity of Clostridium [Clostridioides] difficile infection in a tertiary teaching hospital from Mexico Tijerina Rodríguez, Laura Esther Garza González, Elvira Martínez Meléndez, Adrián Morfín Otero, Rayo Camacho Ortiz, Adrián Gonzalez Diaz, Esteban E. Pérez Gómez, Héctor Raúl Villarreal Treviño, Licet Maldonado Garza, Héctor Jesús Esparza Ahumada, Sergio Rodríguez Noriega, Eduardo RC Medicina Interna, Psiquiatría, Neurología Background: Clostridium difficile infection (CDI) is a leading cause of healthcare-associated diarrhea worldwide. In this study, risk factors associated with the development of severe-complicated and recurrent outcomes in CDI patients in different age groups, including the non-elderly, were assessed in a third-level hospital. Methods: CDI cases were detected by clinical data and polymerase-chain-reaction (PCR). Clinical, demographic, epidemiological, and microbiological risk factors for CDI were evaluated. Results: During the study period, 248 out of 805 patients with nosocomial diarrhea were diagnosed with CDI and the majority were severe-complicated cases (87.90%). Female gender (OR 3.19, 95% CI 1.19e8.55, p ¼ 0.02) and lymphoma (OR 3.95, 95% CI 1.03e15.13, p ¼ 0.04) were risk factors for severe-complicated CDI. Mature adulthood (51e60 years) (OR 5.80, 95% CI 1.56e21.62, p ¼ 0.01), previous rifampicin use (OR 7.44, 95% CI 2.10e26.44, p ¼ 0.00), and neoplasm (solid malignant neoplasm or hematological malignancies) (OR 4.12, 95% CI 1.01e16.83, p ¼ 0.04) were risk factors for recurrent infection. Autoimmune disorders (OR 6.62, CI 95% 1.26e34.73, p ¼ 0.02), leukemia (OR 4.97, 95% CI 1.05e23.58, p ¼ 0.04), lymphoma (OR 3.79, 95% CI 1.03e12.07, p ¼ 0.04) and previous colistin treatment (OR 4.97, 95% CI 1.05e23.58, p ¼ 0.04) were risk factors for 30-day mortality. Conclusion: Newly identified risk factors for recurrent CDI were rifampicin treatment and age between 51 and 60 years; colistin treatment was identified as a risk factor for 30-day mortality. Previously identified risk factors for severe-complicated CDI were confirmed, but with a major impact on non-elderly patients. Elsevier 2021-02-27 Article PeerReviewed text en cc_by_nc_nd http://eprints.uanl.mx/22459/1/22459.pdf http://eprints.uanl.mx/22459/1.haspreviewThumbnailVersion/22459.pdf Tijerina Rodríguez, Laura Esther y Garza González, Elvira y Martínez Meléndez, Adrián y Morfín Otero, Rayo y Camacho Ortiz, Adrián y Gonzalez Diaz, Esteban E. y Pérez Gómez, Héctor Raúl y Villarreal Treviño, Licet y Maldonado Garza, Héctor Jesús y Esparza Ahumada, Sergio y Rodríguez Noriega, Eduardo (2021) Clinical characteristics associated with the severity of Clostridium [Clostridioides] difficile infection in a tertiary teaching hospital from Mexico. Biomedical Journal. pp. 1-6. ISSN 23194170 http://doi.org/10.1016/j.bj.2021.02.007 doi:10.1016/j.bj.2021.02.007 |
| spellingShingle | RC Medicina Interna, Psiquiatría, Neurología Tijerina Rodríguez, Laura Esther Garza González, Elvira Martínez Meléndez, Adrián Morfín Otero, Rayo Camacho Ortiz, Adrián Gonzalez Diaz, Esteban E. Pérez Gómez, Héctor Raúl Villarreal Treviño, Licet Maldonado Garza, Héctor Jesús Esparza Ahumada, Sergio Rodríguez Noriega, Eduardo Clinical characteristics associated with the severity of Clostridium [Clostridioides] difficile infection in a tertiary teaching hospital from Mexico |
| thumbnail | https://rediab.uanl.mx/themes/sandal5/images/online.png |
| title | Clinical characteristics associated with the severity of Clostridium [Clostridioides] difficile infection in a tertiary teaching hospital from Mexico |
| title_full | Clinical characteristics associated with the severity of Clostridium [Clostridioides] difficile infection in a tertiary teaching hospital from Mexico |
| title_fullStr | Clinical characteristics associated with the severity of Clostridium [Clostridioides] difficile infection in a tertiary teaching hospital from Mexico |
| title_full_unstemmed | Clinical characteristics associated with the severity of Clostridium [Clostridioides] difficile infection in a tertiary teaching hospital from Mexico |
| title_short | Clinical characteristics associated with the severity of Clostridium [Clostridioides] difficile infection in a tertiary teaching hospital from Mexico |
| title_sort | clinical characteristics associated with the severity of clostridium clostridioides difficile infection in a tertiary teaching hospital from mexico |
| topic | RC Medicina Interna, Psiquiatría, Neurología |
| url | http://eprints.uanl.mx/22459/1/22459.pdf |
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