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Statements

Subject Item
n2:RIV%2F00216208%3A11140%2F14%3A10227271%21RIV15-MSM-11140___
rdf:type
skos:Concept n12:Vysledek
dcterms:description
OBJECTIVE: Clostridium difficile infection (CDI) has been increasing in incidence, with significant morbidity and mortality, and is subject to geographical and institutional variability. We aimed to characterize epidemiology and clinical manifestations of CDI in a Czech tertiary care center and to identify risk factors of fulminant course. METHODS: All adult patients hospitalized with primary CDI in a 3-year period were retrospectively identified. Epidemiological and clinically descriptive data were extracted from medical records. Multivariate analysis was used to identify the risk factors of fulminant course. The relationship between incidence of CDI and antibiotic consumption was evaluated. RESULTS: Overall, 183 CDI patients, median age 67 years, were enrolled. Hospital-acquired CDI was present in 85% of cases. The incidence of CDI was 1/10 000 patient-days. Hospital-acquired CDI hospital mortality was 22.4%. Severe CDI (SCDI) was identified in 15.8% of patients, with 62% mortality. SCDI patients had longer onset of symptoms to diagnosis interval compared with mild CDI (P=0.05). Multivariate analysis showed that SCDI patients were older (P=0.018), and more frequently had abnormal abdominal physical findings (P=0.001), higher inflammatory markers (P<0.001), higher creatinine (P=0.002), and lower albumin (P<0.001) than patients with mild CDI. Analysis of antibiotic consumption at departments with the highest incidence of CDI showed a trend toward higher incidence of CDI associated with penicillin use (P=0.08) and a negative correlation of CDI incidence with nitroimidazoles consumption (P=0.03). CONCLUSION: CDI is less frequent in the conditions studied compared with literary data; however, the fulminant form has a very high mortality. Delayed recognition and treatment is a crucial determinant of the severity of CDI. The association between CDI and antibiotic consumption is less clear. OBJECTIVE: Clostridium difficile infection (CDI) has been increasing in incidence, with significant morbidity and mortality, and is subject to geographical and institutional variability. We aimed to characterize epidemiology and clinical manifestations of CDI in a Czech tertiary care center and to identify risk factors of fulminant course. METHODS: All adult patients hospitalized with primary CDI in a 3-year period were retrospectively identified. Epidemiological and clinically descriptive data were extracted from medical records. Multivariate analysis was used to identify the risk factors of fulminant course. The relationship between incidence of CDI and antibiotic consumption was evaluated. RESULTS: Overall, 183 CDI patients, median age 67 years, were enrolled. Hospital-acquired CDI was present in 85% of cases. The incidence of CDI was 1/10 000 patient-days. Hospital-acquired CDI hospital mortality was 22.4%. Severe CDI (SCDI) was identified in 15.8% of patients, with 62% mortality. SCDI patients had longer onset of symptoms to diagnosis interval compared with mild CDI (P=0.05). Multivariate analysis showed that SCDI patients were older (P=0.018), and more frequently had abnormal abdominal physical findings (P=0.001), higher inflammatory markers (P<0.001), higher creatinine (P=0.002), and lower albumin (P<0.001) than patients with mild CDI. Analysis of antibiotic consumption at departments with the highest incidence of CDI showed a trend toward higher incidence of CDI associated with penicillin use (P=0.08) and a negative correlation of CDI incidence with nitroimidazoles consumption (P=0.03). CONCLUSION: CDI is less frequent in the conditions studied compared with literary data; however, the fulminant form has a very high mortality. Delayed recognition and treatment is a crucial determinant of the severity of CDI. The association between CDI and antibiotic consumption is less clear.
dcterms:title
Clostridium difficile infection in hospitalized patients at a Czech tertiary center: analysis of epidemiology, clinical features, and risk factors of fulminant course Clostridium difficile infection in hospitalized patients at a Czech tertiary center: analysis of epidemiology, clinical features, and risk factors of fulminant course
skos:prefLabel
Clostridium difficile infection in hospitalized patients at a Czech tertiary center: analysis of epidemiology, clinical features, and risk factors of fulminant course Clostridium difficile infection in hospitalized patients at a Czech tertiary center: analysis of epidemiology, clinical features, and risk factors of fulminant course
skos:notation
RIV/00216208:11140/14:10227271!RIV15-MSM-11140___
n3:aktivita
n14:I
n3:aktivity
I
n3:cisloPeriodika
8
n3:dodaniDat
n4:2015
n3:domaciTvurceVysledku
n10:9352163 n10:7263473 n10:1847554 n10:8919844 n10:5081297 n10:7935501
n3:druhVysledku
n15:J
n3:duvernostUdaju
n18:S
n3:entitaPredkladatele
n17:predkladatel
n3:idSjednocenehoVysledku
7559
n3:idVysledku
RIV/00216208:11140/14:10227271
n3:jazykVysledku
n9:eng
n3:klicovaSlova
risk factors; mortality; incidence; Clostridium difficile infection; antibiotic consumption
n3:klicoveSlovo
n11:antibiotic%20consumption n11:incidence n11:Clostridium%20difficile%20infection n11:mortality n11:risk%20factors
n3:kodStatuVydavatele
US - Spojené státy americké
n3:kontrolniKodProRIV
[D1DA610DC952]
n3:nazevZdroje
European Journal of Gastroenterology and Hepatology
n3:obor
n7:FE
n3:pocetDomacichTvurcuVysledku
6
n3:pocetTvurcuVysledku
9
n3:rokUplatneniVysledku
n4:2014
n3:svazekPeriodika
26
n3:tvurceVysledku
Krčma, Michal Fremundová, Lucie Kozák, Filip Geigerová, Lenka Matějovič, Martin Koželuhová, Jana Balihar, Karel Bergerová, Tamara Hejda, Václav
n3:wos
000338722300008
s:issn
0954-691X
s:numberOfPages
8
n13:doi
10.1097/MEG.0000000000000139
n16:organizacniJednotka
11140