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Journal Articles Antibiotics Year : 2021

Mortality Following Clostridioides difficile Infection in Europe: A Retrospective Multicenter Case-Control Study

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David A Enoch
  • Function : Author
  • PersonId : 1176012
Márta Patyi
  • Function : Author
  • PersonId : 1176013
Aleksander Deptuła
  • Function : Author
  • PersonId : 1176014
Antonella Agodi
Marcin Fedewicz
  • Function : Author
  • PersonId : 1176022
Mateusz Michalak
  • Function : Author
  • PersonId : 1176023
Lorra Monpierre
  • Function : Author
  • PersonId : 1176024
Theodore Gouliouris
  • Function : Author
  • PersonId : 1176025
Dorota Wultańska

Abstract

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, and cognitive 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 a fatal outcome.
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Dates and versions

hal-03819934 , version 1 (19-10-2022)

Licence

Attribution - CC BY 4.0

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Jacek Czepiel, Marcela Krutova, Assaf Mizrahi, Nagham Khanafer, David A Enoch, et al.. Mortality Following Clostridioides difficile Infection in Europe: A Retrospective Multicenter Case-Control Study. Antibiotics, 2021, 10, pp.1-11. ⟨10.3390/antibiotics10030299⟩. ⟨hal-03819934⟩
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