Clostridium difficile Severity and Outcome at a North of Portugal Healthcare Facility

Authors

  • João Barbosa-Martins Internal Medicine Department. Hospital da Senhora da Oliveira. Guimarães. Medical Oncology Department. Hospital da Senhora da Oliveira. Guimarães. https://orcid.org/0000-0003-0518-3769
  • Joana Mendonça Internal Medicine Department. Hospital da Senhora da Oliveira. Guimarães. Medical Oncology Department. Hospital da Senhora da Oliveira. Guimarães.
  • Carolina Carvalho Medical Oncology Department. Hospital da Senhora da Oliveira. Guimarães.
  • Helena Sarmento Internal Medicine Department. Hospital da Senhora da Oliveira. Guimarães.
  • Paula Mota Clinical Pathology Department. Hospital da Senhora da Oliveira. Guimarães.
  • Camila Coutinho Medical Oncology Department. Hospital da Senhora da Oliveira. Guimarães.
  • Jorge Cotter Internal Medicine Department. Hospital da Senhora da Oliveira. Guimarães.

DOI:

https://doi.org/10.20344/amp.16357

Keywords:

Clostridioides difficile, Clostridium Infections/diagnosis, Clostridium Infections/epidemiology, Risk Factors, Severity of Illness Index, Treatment Outcome

Abstract

Introduction: 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.

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Published

2022-04-01

How to Cite

1.
Barbosa-Martins J, Mendonça J, Carvalho C, Sarmento H, Mota P, Coutinho C, Cotter J. Clostridium difficile Severity and Outcome at a North of Portugal Healthcare Facility. Acta Med Port [Internet]. 2022 Apr. 1 [cited 2024 Apr. 21];35(4):279-85. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/16357

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Section

Original