Open AccessClostridium difficile Severity and Outcome at a North of Portugal Healthcare Facility
Author(s) -
João Barbosa-Martins,
Joana Mendonça,
Carolina Muniz Carvalho,
Helena Sarmento,
Paula Mota,
C. Coutinho,
Jorge Cotter
Publication year - 2022
Publication title -
acta médica portuguesa
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.316
H-Index - 21
eISSN - 1646-0758
pISSN - 0870-399X
DOI - 10.20344/amp.16357
Subject(s) - medicine , clostridium difficile , fulminant , retrospective cohort study , disease , antibiotics , intensive care medicine , microbiology and biotechnology , biology
Clostridium difficile infection has been increasingly reported, with a significant healthcare burden and important morbimortality. This study aimed to characterize and describe the severity and outcomes of this event at a Portuguese hospital.Material and Methods: We conducted a retrospective analysis, by clinical record review, of all confirmed cases diagnosed in a hospital in the North of Portugal, between January 2013 and December 2018. We included those who were non-pregnant and at least 18 years old.Results: Fifty-seven cases occurred, mostly in females and aged patients; 33.3% were healthcare facility-outset, while 31.6% were community-associated. Regarding severity, 43.9% had non-severe, while 29.8% severe and 21.0% fulminant presentations, the latter with the need of admission. Exposure to antibiotics occurred in 68.4%, while to proton-pump inhibitors in 57.9%. Risk factors for severe disease were female gender, chronic renal disease, and high neutrophil-lymphocyte ratio. Moreover, renal disease and a higher ratio were associated with fulminant disease. Thirty-day all-cause mortality was found in 15.8% while 90-day in 28.1%. Risk factors for 30-day mortality were renal disease, higher Charlson score, and higher neutrophil-lymphocyte ratio. Risk factors for 90-day mortality were advanced age, previous antibiotic exposure, higher Charlson score, and higher neutrophil-lymphocyte ratio.Conclusion: Data concerning Clostridium difficile infection severity and prognosis in Portugal is scarce, and future studies should focus on this important topic.