Burden of Clostridium difficile infection between 2010 and 2013:Trends and outcomes from an academic center in Eastern Europe

作     者：Zsuzsanna Kurti Barbara D Lovasz Michael D Mandel Zoltan Csima Petra A Golovics Bence D Csako Anna Mohas Lorant Gnczi Krisztina B Gecse Lajos S Kiss Miklos Szathmari Peter L Lakatos 

作者机构：1~(st) Department of MedicineSemmelweis University Institute of Health Care Development and Clinical MethodologySemmelweis University 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2015年第21卷第21期

页      面：6728-6735页

核心收录：

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 100401[医学-流行病与卫生统计学] 10[医学] 

主　　题：Clostridium difficile infection Hospitalization Antibiotics Proton pump inhibitors 

摘      要：AIM:To analyze the incidence and possible risk factors in hospitalized patients treated with Clostridium difficile infection(CDI).METHODS:A total of 11751 patients were admitted to our clinic between 1 January 2010 and 1 *** hundred and forty-seven inpatients were prospectively diagnosed with *** the risk analysis a 1:3 matching was *** of 732 patients matched for age,sex,and inpatient care period and unit were compared to those of the CDI *** records were collected from an electronic hospital database and comprehensively ***:Incidence of CDI was 21.0/1000 admissions(2.1%of all-cause hospitalizations and 4.45%of total inpatient days).The incidence of severe CDI was 12.6%(2.63/1000 of all-cause hospitalizations).Distribution of CDI cases was different according to the unit type,with highest incidence rates in hematology,gastroenterology and nephrology units(32.9,25 and24.6/1000 admissions,respectively) and lowest rates in 1.4%(33/2312) in endocrinology and general internal medicine(14.2 and 16.9/1000 admissions)*** of CDI was 11.3%within 12 wk after *** of hospital stay was longer in patients with CDI compared to controls(17.6 ± 10.8d vs 12.4 ± 7.71 d).CDI accounted for 6.3%of allinpatient deaths,and 30-d mortality rate was 21.9%(54/247 cases).Risk factors for CDI were antibiotic therapy[including third-generation cephalosporins or fluoroquinolones,odds ratio(OR) = 4.559;P 0.001],use of proton pump inhibitors(OR = 2.082,P 0.001),previous hospitaiization within 12 mo(OR = 3.167,P 0.001),previous CDI(OR = 15.32;P 0.001),while presence of diabetes mellitus was associated with a decreased risk for CDI(OR = 0.484;P 0.001).Treatment of recurrent cases was significantly different from primary infections with more frequent use of vancomycin alone or in combination(P 0.001),and antibiotic therapy duration was longer(P 0.02).Severity,mortality and outcome of primary infections and relapsing