Dataset Information

Prospective Study on Incidence, Risk Factors and Outcome of Recurrent Clostridioides difficile Infections.

ABSTRACT: Limited and wide-ranging data are available on the recurrent Clostridioides difficile infection (rCDI) incidence rate. We performed a cohort study with the aim to assess the incidence of and risk factors for rCDI. Adult patients with a first CDI, hospitalized in 15 Italian hospitals, were prospectively included and followed-up for 30 d after the end of antimicrobial treatment for their first CDI. A case-control study was performed to identify risk factors associated with 30-day onset rCDI. Three hundred nine patients with a first CDI were included in the study; 32% of the CDI episodes (99/309) were severe/complicated; complete follow-up was available for 288 patients (19 died during the first CDI episode, and 2 were lost during follow-up). At the end of the study, the crude all-cause mortality rate was 10.7% (33 deaths/309 patients). Two hundred seventy-one patients completed the follow-up; rCDI occurred in 21% of patients (56/271) with an incidence rate of 72/10,000 patient-days. Logistic regression analysis identified exposure to cephalosporin as an independent risk factor associated with rCDI (RR: 1.7; 95% CI: 1.1-2.7, p = 0.03). Our study confirms the relevance of rCDI in terms of morbidity and mortality and provides a reliable estimation of its incidence.

SUBMITTER: Granata G

PROVIDER: S-EPMC7962640 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Prospective Study on Incidence, Risk Factors and Outcome of Recurrent <i>Clostridioides difficile</i> Infections.

Granata Guido G Petrosillo Nicola N Adamoli Lucia L Bartoletti Michele M Bartoloni Alessandro A Basile Gregorio G Bassetti Matteo M Bonfanti Paolo P Borromeo Raffaella R Ceccarelli Giancarlo G De Luca Anna Maria AM Di Bella Stefano S Fossati Sara S Franceschini Erica E Gentile Ivan I Giacobbe Daniele Roberto DR Giacometti Enrica E Ingrassia Fabrizio F Lagi Filippo F Lobreglio Giambattista G Lombardi Andrea A Lupo Laura Isabella LI Luzzati Roberto R Maraolo Alberto Enrico AE Mikulska Malgorzata M Mondelli Mario Umberto MU Mularoni Alessandra A Mussini Cristina C Oliva Alessandra A Pandolfo Alessandro A Rogati Carlotta C Trapani Filippo Fabio FF Venditti Mario M Viale Pierluigi P Caraffa Emanuela E Cataldo Maria Adriana MA On Behalf Of The ReCloDi Recurrence Of Clostridioides Difficile Infection Study Group

Journal of clinical medicine 20210308 5

<h4>Background</h4>Limited and wide-ranging data are available on the recurrent <i>Clostridioides difficile</i> infection (rCDI) incidence rate.<h4>Methods</h4>We performed a cohort study with the aim to assess the incidence of and risk factors for rCDI. Adult patients with a first CDI, hospitalized in 15 Italian hospitals, were prospectively included and followed-up for 30 d after the end of antimicrobial treatment for their first CDI. A case-control study was performed to identify risk factors ...[more]

PMID: 33800334

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Project description:BackgroundThe health-related quality of life (HrQoL) can be substantially affected in patients with recurrent Clostridioides difficile infection (rCDI) but the impact of effective treatment of the infection remains unclear. This study aimed to evaluate the HrQoL in patients with rCDI and estimate the gain in HrQoL associated with effective treatment of rCDI.MethodsPatients' HrQoL was estimated based on EuroQol 5-Dimensions 3-Levels (EQ-5D-3L) questionnaires obtained from a Danish randomised controlled trial (RCT). In the RCT, 64 patients with rCDI were randomised to receive either vancomycin (n = 16), fidaxomicin (n = 24) or faecal microbiota transplantation (FMT) preceded by vancomycin (n = 24). The primary outcome in the RCT was rCDI resolution. Patients were closely monitored during the RCT, and rescue FMT was offered to those who failed their primary treatment. Patients' HrQoL was measured at baseline and at 8- and 26-weeks follow-up. Linear regression analyses conditional on the differences between baseline and follow-up measurements were used to assess statistical significance (p < 0.05).ResultsWithin 26 weeks of follow-up, 13 (81%) patients treated with vancomycin, 12 (50%) patients treated with fidaxomicin, and 3 (13%) patients treated with FMT had a subsequent recurrence and received a rescue FMT. The average HrQoL for untreated patients with rCDI was 0.675. After receiving effective treatment, this value increased by 0.139 to 0.813 (p < 0.001) at week 8 and by 0.098 to 0.773 (p = 0.003) at week 26 of follow-up compared with baseline.ConclusionThe HrQoL was adversely affected in patients with an active episode of rCDI but increased substantially after receiving an effective treatment algorithm in which rescue FMT was provided in case of a primary treatment failure.Trial registrationThe RCT was preregistered at EudraCT (j.no. 2015-003004-24, https://www.clinicaltrialsregister.eu/ctr-search/trial/2015-003004-24/results) and at ClinicalTrials.gov (study identifier NCT02743234, https://clinicaltrials.gov/ct2/show/NCT02743234).

Dataset Information

Prospective Study on Incidence, Risk Factors and Outcome of Recurrent Clostridioides difficile Infections.

Publications

Prospective Study on Incidence, Risk Factors and Outcome of Recurrent <i>Clostridioides difficile</i> Infections.

Similar Datasets

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