Dataset Information

Mortality Following Clostridioides difficile Infection in Europe: A Retrospective Multicenter Case-Control Study.

ABSTRACT: We aimed to describe the clinical presentation, treatment, outcome and report on factors associated with mortality over a 90-day period in Clostridioides difficile infection (CDI). Descriptive, univariate, and multivariate regression analyses were performed on data collected in a retrospective case-control study conducted in nine hospitals from seven European countries. A total of 624 patients were included, of which 415 were deceased (cases) and 209 were still alive 90 days after a CDI diagnosis (controls). The most common antibiotics used previously in both groups were β-lactams; previous exposure to fluoroquinolones was significantly (p = 0.0004) greater in deceased patients. Multivariate logistic regression showed that the factors independently related with death during CDI were older age, inadequate CDI therapy, cachexia, malignancy, Charlson Index, long-term care, elevated white blood cell count (WBC), C-reactive protein (CRP), bacteraemia, complications, and cognitive impairment. In addition, older age, higher levels of WBC, neutrophil, CRP or creatinine, the presence of malignancy, cognitive impairment, and complications were strongly correlated with shortening the time from CDI diagnosis to death. CDI prevention should be primarily focused on hospitalised elderly people receiving antibiotics. WBC, neutrophil count, CRP, creatinine, albumin and lactate levels should be tested in every hospitalised patient treated for CDI to assess the risk of a fatal outcome.

SUBMITTER: Czepiel J

PROVIDER: S-EPMC7998379 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Mortality Following <i>Clostridioides difficile</i> Infection in Europe: A Retrospective Multicenter Case-Control Study.

Czepiel Jacek J Krutova Marcela M Mizrahi Assaf A Khanafer Nagham N Enoch David A DA Patyi Márta M Deptuła Aleksander A Agodi Antonella A Nuvials Xavier X Pituch Hanna H Wójcik-Bugajska Małgorzata M Filipczak-Bryniarska Iwona I Brzozowski Bartosz B Krzanowski Marcin M Konturek Katarzyna K Fedewicz Marcin M Michalak Mateusz M Monpierre Lorra L Vanhems Philippe P Gouliouris Theodore T Jurczyszyn Artur A Goldman-Mazur Sarah S Wultańska Dorota D Kuijper Ed J EJ Skupień Jan J Biesiada Grażyna G Garlicki Aleksander A

Antibiotics (Basel, Switzerland) 20210313 3

We aimed to describe the clinical presentation, treatment, outcome and report on factors associated with mortality over a 90-day period in <i>Clostridioides difficile</i> infection (CDI). Descriptive, univariate, and multivariate regression analyses were performed on data collected in a retrospective case-control study conducted in nine hospitals from seven European countries. A total of 624 patients were included, of which 415 were deceased (cases) and 209 were still alive 90 days after a CDI d ...[more]

PMID: 33805755

Similar Datasets

Project description:ObjectiveFecal microbiota transplantation (FMT) is a highly effective treatment for Clostridioides difficile infection (CDI). However, the fecal transplant's causal components translating into clearance of the CDI are yet to be identified. The commensal bacteria Faecalibacterium prausnitzii may be of great interest in this context, since it is one of the most common species of the healthy gut microbiota and produces metabolites with anti-inflammatory properties. Although there is mounting evidence that F. prausnitzii is an important regulator of intestinal homeostasis, data about its role in CDI and FMT are relatively scarce.MethodsStool samples from patients with recurrent CDI were collected to investigate the relative abundance of F. prausnitzii before and after FMT. Twenty-one patients provided fecal samples before the FMT procedure, at 2 weeks post-FMT, and at 2-4 months post-FMT. The relative abundance of F. prausnitzii was determined using quantitative polymerase chain reaction.ResultsThe abundance of F. prausnitzii was elevated in samples (N = 9) from donors compared to pre-FMT samples (N = 15) from patients (adjusted P<0.001). No significant difference in the abundance of F. prausnitzii between responders (N = 11) and non-responders (N = 4) was found before FMT (P = 0.85). In patients with CDI, the abundance of F. prausnitzii significantly increased in the 2 weeks post-FMT samples (N = 14) compared to the pre-FMT samples (N = 15, adjusted P<0.001). The increase persisted 2-4 months post-FMT (N = 15) compared to pre-FMT samples (N = 15) (adjusted P<0.001).ConclusionsFMT increases the relative abundance of F. prausnitzii in patients with recurrent CDI, and this microbial shift remains several months later. The baseline abundance of F. prausnitzii in donors or recipients was not associated with future treatment response, although a true predictive capacity cannot be excluded because of the limited sample size. Further studies are needed to discern whether F. prausnitzii plays an active role in the resolution of CDI.

Dataset Information

Mortality Following Clostridioides difficile Infection in Europe: A Retrospective Multicenter Case-Control Study.

Publications

Mortality Following <i>Clostridioides difficile</i> Infection in Europe: A Retrospective Multicenter Case-Control Study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets