Literature DB >> 27501856

Can we improve the therapy of Clostridium difficile infection in elderly patients?

Katarina Bielakova1, Emmanuela Fernandova2, Hana Matejovska-Kubesova2, Pavel Weber2, Dana Prudius2, Josef Bednar3.   

Abstract

BACKGROUND: Clostridium difficile infection (CDI) is becoming a serious problem predominantly in geriatric patients, who are a significant risk group. The goal of this study was to evaluate the risk factors for mortality in CDI patients and to construct a binary logistic regression model that describes the probability of mortality in geriatric patients suffering from CDI.
METHODS: In this retrospective study, we evaluated a group of 235 patients over 65 years of age with confirmed diagnoses of CDI, hospitalized at the Department of Internal Medicine, Geriatrics and General Practice, Brno, from January 2008 to December 2013. The examined group comprised 148 women (63 %) and 87 men (37 %). For the diagnosis of CDI, confirmation of A and B toxins in the patients' stool or an autopsy confirmation was crucial.
RESULTS: The impact of antibiotic therapy on the increased incidence of CDI was clearly confirmed in our study group when examining patients' histories. Other risk factors included cerebrovascular disease, dementia, the presence of pressure ulcers, and immobility. Our new model consisted of a combination of the following parameters: the number of antibiotics used (from patients' history), nutritional status (Mini Nutritional Assessment short-form test), presence of pressure ulcers, and occurrence of fever.
CONCLUSION: Our logistic regression model may predict mortality in geriatric patients suffering from CDI. This could help improve the therapeutic process.

Entities:  

Keywords:  Antibiotic therapy; Binary logistic regression model; Clostridium difficile; Geriatric patient; Pseudomebranous colitis

Mesh:

Substances:

Year:  2016        PMID: 27501856     DOI: 10.1007/s00508-016-1056-z

Source DB:  PubMed          Journal:  Wien Klin Wochenschr        ISSN: 0043-5325            Impact factor:   1.704


  22 in total

1.  European Society of Clinical Microbiology and Infectious Diseases (ESCMID): treatment guidance document for Clostridium difficile infection (CDI).

Authors:  M P Bauer; E J Kuijper; J T van Dissel
Journal:  Clin Microbiol Infect       Date:  2009-12       Impact factor: 8.067

2.  Health care-associated Clostridium difficile infection in Canada: patient age and infecting strain type are highly predictive of severe outcome and mortality.

Authors:  Mark Miller; Denise Gravel; Michael Mulvey; Geoffrey Taylor; David Boyd; Andrew Simor; Michael Gardam; Allison McGeer; James Hutchinson; Dorothy Moore; Sharon Kelly
Journal:  Clin Infect Dis       Date:  2010-01-15       Impact factor: 9.079

Review 3.  Emergence of Clostridium difficile-associated disease in North America and Europe.

Authors:  E J Kuijper; B Coignard; P Tüll
Journal:  Clin Microbiol Infect       Date:  2006-10       Impact factor: 8.067

4.  Risk factors for Clostridium difficile toxin-positive nosocomial diarrhoea.

Authors:  David Raveh; Bella Rabinowitz; Gabriel S Breuer; Bernard Rudensky; Amos M Yinnon
Journal:  Int J Antimicrob Agents       Date:  2006-09       Impact factor: 5.283

5.  Clostridium difficile-associated diarrhea in a region of Quebec from 1991 to 2003: a changing pattern of disease severity.

Authors:  Jacques Pépin; Louis Valiquette; Marie-Eve Alary; Philippe Villemure; Annick Pelletier; Karine Forget; Karine Pépin; Daniel Chouinard
Journal:  CMAJ       Date:  2004-08-31       Impact factor: 8.262

6.  Comparison of nine commercially available Clostridium difficile toxin detection assays, a real-time PCR assay for C. difficile tcdB, and a glutamate dehydrogenase detection assay to cytotoxin testing and cytotoxigenic culture methods.

Authors:  Kerrie Eastwood; Patrick Else; André Charlett; Mark Wilcox
Journal:  J Clin Microbiol       Date:  2009-08-26       Impact factor: 5.948

7.  Risk factors for Clostridium difficile infection.

Authors:  G E Bignardi
Journal:  J Hosp Infect       Date:  1998-09       Impact factor: 3.926

8.  Clostridium difficile infection in the "oldest" old: clinical outcomes in patients aged 80 and older.

Authors:  Eric D Cober; Preeti N Malani
Journal:  J Am Geriatr Soc       Date:  2009-04       Impact factor: 5.562

9.  Increase in adult Clostridium difficile-related hospitalizations and case-fatality rate, United States, 2000-2005.

Authors:  Marya D Zilberberg; Andrew F Shorr; Marin H Kollef
Journal:  Emerg Infect Dis       Date:  2008-06       Impact factor: 6.883

10.  Derivation and validation of a simple clinical bedside score (ATLAS) for Clostridium difficile infection which predicts response to therapy.

Authors:  Mark A Miller; Thomas Louie; Kathleen Mullane; Karl Weiss; Arnold Lentnek; Yoav Golan; Yin Kean; Pam Sears
Journal:  BMC Infect Dis       Date:  2013-03-25       Impact factor: 3.090

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  1 in total

1.  Association Between Immunosuppressive Therapy and Outcome of Clostridioides difficile Infection: Systematic Review and Meta-Analysis.

Authors:  Yiting Li; Haifeng Cai; Daniel A Sussman; Jean Donet; Kevin Dholaria; Jiajia Yang; Ami Panara; Ryan Croteau; Jamie S Barkin
Journal:  Dig Dis Sci       Date:  2021-09-23       Impact factor: 3.487

  1 in total

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