1. Prospective Study on Incidence, Risk Factors and Outcome of Recurrent
- Author
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Erica Franceschini, Malgorzata Mikulska, Andrea Lombardi, Gregorio Basile, Laura Isabella Lupo, Giambattista Lobreglio, Daniele Roberto Giacobbe, Giancarlo Ceccarelli, Maria Adriana Cataldo, Anna Maria De Luca, Mario Venditti, Stefano Di Bella, Emanuela Caraffa, Michele Bartoletti, Enrica Giacometti, Nicola Petrosillo, Matteo Bassetti, Alessandra Oliva, Guido Granata, Ivan Gentile, Pierluigi Viale, Cristina Mussini, Alessandro Pandolfo, Paolo Bonfanti, Raffaella Borromeo, Sara Fossati, Alessandra Mularoni, Lucia Adamoli, Fabrizio Ingrassia, Filippo Lagi, Alberto Enrico Maraolo, Carlotta Rogati, Filippo Trapani, Roberto Luzzati, Alessandro Bartoloni, Mario U. Mondelli, Granata, G, Petrosillo, N, Adamoli, L, Bartoletti, M, Bartoloni, A, Basile, G, Bassetti, M, Bonfanti, P, Borromeo, R, Ceccarelli, G, De Luca, A, Di Bella, S, Fossati, S, Franceschini, E, Gentile, I, Giacobbe, D, Giacometti, E, Ingrassia, F, Lagi, F, Lobreglio, G, Lombardi, A, Lupo, L, Luzzati, R, Maraolo, A, Mikulska, M, Mondelli, M, Mularoni, A, Mussini, C, Oliva, A, Pandolfo, A, Rogati, C, Trapani, F, Venditti, M, Viale, P, Caraffa, E, Cataldo, M, 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, Granata G., Petrosillo N., Adamoli L., Bartoletti M., Bartoloni A., Basile G., Bassetti M., Bonfanti P., Borromeo R., Ceccarelli G., De Luca A.M., Di Bella S., Fossati S., Franceschini E., Gentile I., Giacobbe D.R., Giacometti E., Ingrassia F., Lagi F., Lobreglio G., Lombardi A., Lupo L.I., Luzzati R., Maraolo A.E., Mikulska M., Mondelli M.U., Mularoni A., Mussini C., Oliva A., Pandolfo A., Rogati C., Trapani F.F., Venditti M., Viale P., Caraffa E., and Cataldo M.A.
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medicine.medical_specialty ,recurrence ,genetic structures ,lcsh:Medicine ,Logistic regression ,Clostridioides difficile ,Article ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Medicine ,risk factors ,030212 general & internal medicine ,Risk factor ,Prospective cohort study ,0303 health sciences ,Adult patients ,030306 microbiology ,business.industry ,Incidence (epidemiology) ,Mortality rate ,lcsh:R ,General Medicine ,risk factor ,outcome ,incidence ,business ,Clostridioides ,Cohort study - 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.
- Published
- 2020