Is Clostridium difficile infection an increasingly common severe disease in adult intensive care units? A 10-year experience

Journal of Critical Care
E BouzaE Reigadas

Abstract

Despite the high concentration of patients with known risk factors for Clostridium difficile infection (CDI) in intensive care units (ICUs), data on ICU patients are scarce. The aim of this study was describe the incidence, clinical characteristics, and evolution of CDI in critically ill patients. From 2003 to 2012, adult patients admitted to an ICU (A-ICU) and positive for CDI were included and classified as follows: pre-ICU, if the positive sample was obtained within ±3 days of ICU admission; in-ICU, if obtained after 3 days of ICU admission and up to 3 days after ICU discharge. We recorded 4095 CDI episodes, of which 328 were A-ICU (8%). Episodes of A-ICU decreased from 19.4 to 8.7 per 10000 ICU days of stay (P < .0001). Most A-ICU CDIs (66.3%) were mild to moderate. Pre-ICU episodes accounted for 16.2% and were more severe complicated than in-ICU episodes (11% vs 0%; P = .020). Overall mortality was 28.6%, and CDI-attributable mortality was only 3%. The incidence of A-ICU CDI has decreased steadily over the last 10 years. A significant proportion of A-ICU CDI episodes are pre-ICU and are more severe than in-ICU CDI episodes. Most episodes of A-ICU CDI were nonsevere, with low associated mortality.

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Citations

Feb 26, 2016·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Karn WijarnpreechaKiran Nakkala
Aug 16, 2016·Infectious Diseases and Therapy·Alberto Cózar-LlistóJavier Cobo
Mar 28, 2017·Journal of Medical Economics·Jesus Ruiz-RamosPaula Ramirez
Jul 12, 2018·Medizinische Klinik, Intensivmedizin und Notfallmedizin·F Prechter, A Stallmach
Dec 10, 2019·Critical Care : the Official Journal of the Critical Care Forum·Carolin F MantheyValentin Fuhrmann
Oct 24, 2017·Critical Care : the Official Journal of the Critical Care Forum·Florian PrechterAndreas Stallmach
Aug 3, 2020·Current Opinion in Critical Care·Benoit GuerySarah Tschudin-Sutter
Feb 14, 2021·European Journal of Hospital Pharmacy. Science and Practice·Bojana MilenkovićSandra Vezmar Kovačević

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