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Prospective Study on Incidence, Risk Factors and Outcome of Recurrent Clostridioides difficile Infections

2021; Multidisciplinary Digital Publishing Institute; Volume: 10; Issue: 5 Linguagem: Inglês

10.3390/jcm10051127

2077-0383

Guido Granata, Nicola Petrosillo, Lucia Adamoli, Michele Bartoletti, Alessandro Bartoloni, Gregorio Basile, Matteo Bassetti, Paolo Bonfanti, Raffaella Borromeo, Giancarlo Ceccarelli, Anna Irene De Luca, Stefano Di Bella, Sara Fossati, Erica Franceschini, Ivan Gentile, Daniele Roberto Giacobbe, Enrica Giacometti, F Ingrassia, Filippo Lagi, Giambattista Lobreglio, Andrea Lombardi, Laura Isabella Lupo, Roberto Luzzati, Alberto Enrico Maraolo, Małgorzata Mikulska, Mario U. Mondelli, Alessandra Mularoni, Cristina Mussini, Alessandra Oliva, Alessandro Pandolfo, Carlotta Rogati, Filippo Trapani, Mario Venditti, Pierluigi Viale, Emanuela Caraffa, Maria Adriana Cataldo,

Nosocomial Infections in ICU

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.