Epidemiological and clinical features of patients with Clostridoides difficile infection

AIM: Investigation and identification of epidemiological characteristics, risk factors and treatment regimens effectivity in reducing morbidity and mortality. BACKGROUND: C.difficile remains the leading cause of health care associated diarrhea, usually as a result of irrational use of antimicrobial...

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Main Authors: Arlinda Lloga Osmani, Georgi Eftimovski, Ivan Vidinic, Kostadin Poposki, Dajana Georgievska, Zhaklina Shopova
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Journal of Global Antimicrobial Resistance
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213716524003345
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author Arlinda Lloga Osmani
Georgi Eftimovski
Ivan Vidinic
Kostadin Poposki
Dajana Georgievska
Zhaklina Shopova
author_facet Arlinda Lloga Osmani
Georgi Eftimovski
Ivan Vidinic
Kostadin Poposki
Dajana Georgievska
Zhaklina Shopova
author_sort Arlinda Lloga Osmani
collection DOAJ
description AIM: Investigation and identification of epidemiological characteristics, risk factors and treatment regimens effectivity in reducing morbidity and mortality. BACKGROUND: C.difficile remains the leading cause of health care associated diarrhea, usually as a result of irrational use of antimicrobial therapy. METHODS: Retrospective descriptive study (October 2020-january2024) included all patients with clinical symptoms of Clostridoides difficile infection (CDI) admitted at our clinic. Diagnosis is based on isolation with coproculture for C.difficile, toxin confirmation with immunochromatography, small number confirmed with PCR film array. RESULTS: 594 inpatients with clinical symptoms of CDI were evaluated and diagnosis was confirmed in 44. Average mean age was 58,5 (29-90)years, approximately with no differencies on sex representation. Comorbidities and previous hospitalisations were noted in two third of them, and 63% had used antimicrobial drugs, while 34% had history of corticosteroid usage and 4,5% imunosupressive therapy. Often used antibiotics cephalosporins, clindamycine, quinolones and macrolides. 68,2% had history of protein pump inhibitors usage. Culture positive were 38%, toxinA/B is confirmed with immunochromatography in 77% of patients, PCR film array confirmed C.difficile toxin A/B in the remaining patients. Treatment is carried out with oral vancomycine in 56% of patients, 15% with metronidazole and the remaining with combination of two drugs. Regarding outcomes 90% of patients were cured while 10% had fatal outcomes and CDI is not considered the main cause of death. CONCLUSION: Elderly patients with antibiotic history treatment, previous healthcare exposures and comorbidities were the most affected by CDI infection. Metronidazole and vancomycine has shown good therapeutic results.
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spelling doaj-art-530c0decc37544aa9d28e3ac3b18187f2024-12-27T04:08:38ZengElsevierJournal of Global Antimicrobial Resistance2213-71652024-12-013949Epidemiological and clinical features of patients with Clostridoides difficile infectionArlinda Lloga Osmani0Georgi Eftimovski1Ivan Vidinic2Kostadin Poposki3Dajana Georgievska4Zhaklina Shopova5Clinic for infectious disease Skopje, North MacedoniaClinic for infectious disease Skopje, North MacedoniaClinic for infectious disease Skopje, North MacedoniaClinic for infectious disease Skopje, North MacedoniaClinic for infectious disease Skopje, North MacedoniaClinic for infectious disease Skopje, North MacedoniaAIM: Investigation and identification of epidemiological characteristics, risk factors and treatment regimens effectivity in reducing morbidity and mortality. BACKGROUND: C.difficile remains the leading cause of health care associated diarrhea, usually as a result of irrational use of antimicrobial therapy. METHODS: Retrospective descriptive study (October 2020-january2024) included all patients with clinical symptoms of Clostridoides difficile infection (CDI) admitted at our clinic. Diagnosis is based on isolation with coproculture for C.difficile, toxin confirmation with immunochromatography, small number confirmed with PCR film array. RESULTS: 594 inpatients with clinical symptoms of CDI were evaluated and diagnosis was confirmed in 44. Average mean age was 58,5 (29-90)years, approximately with no differencies on sex representation. Comorbidities and previous hospitalisations were noted in two third of them, and 63% had used antimicrobial drugs, while 34% had history of corticosteroid usage and 4,5% imunosupressive therapy. Often used antibiotics cephalosporins, clindamycine, quinolones and macrolides. 68,2% had history of protein pump inhibitors usage. Culture positive were 38%, toxinA/B is confirmed with immunochromatography in 77% of patients, PCR film array confirmed C.difficile toxin A/B in the remaining patients. Treatment is carried out with oral vancomycine in 56% of patients, 15% with metronidazole and the remaining with combination of two drugs. Regarding outcomes 90% of patients were cured while 10% had fatal outcomes and CDI is not considered the main cause of death. CONCLUSION: Elderly patients with antibiotic history treatment, previous healthcare exposures and comorbidities were the most affected by CDI infection. Metronidazole and vancomycine has shown good therapeutic results.http://www.sciencedirect.com/science/article/pii/S2213716524003345clostridoides difficilerisk factorsantimicrobial therapy
spellingShingle Arlinda Lloga Osmani
Georgi Eftimovski
Ivan Vidinic
Kostadin Poposki
Dajana Georgievska
Zhaklina Shopova
Epidemiological and clinical features of patients with Clostridoides difficile infection
Journal of Global Antimicrobial Resistance
clostridoides difficile
risk factors
antimicrobial therapy
title Epidemiological and clinical features of patients with Clostridoides difficile infection
title_full Epidemiological and clinical features of patients with Clostridoides difficile infection
title_fullStr Epidemiological and clinical features of patients with Clostridoides difficile infection
title_full_unstemmed Epidemiological and clinical features of patients with Clostridoides difficile infection
title_short Epidemiological and clinical features of patients with Clostridoides difficile infection
title_sort epidemiological and clinical features of patients with clostridoides difficile infection
topic clostridoides difficile
risk factors
antimicrobial therapy
url http://www.sciencedirect.com/science/article/pii/S2213716524003345
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AT kostadinpoposki epidemiologicalandclinicalfeaturesofpatientswithclostridoidesdifficileinfection
AT dajanageorgievska epidemiologicalandclinicalfeaturesofpatientswithclostridoidesdifficileinfection
AT zhaklinashopova epidemiologicalandclinicalfeaturesofpatientswithclostridoidesdifficileinfection