Clinical outcomes of Clostridium difficile infection according to strain type : A prospective study in medical wards
Articolo
Data di Pubblicazione:
2018
Citazione:
Clinical outcomes of Clostridium difficile infection according to strain type : A prospective study in medical wards / S. Serafino, . Consonni, M. Migone De Amicis, F. Sisto, G. Domeniconi, S. Formica, M. Zarantonello, A. Maraschin, M.D. Cappellini, P. Spigaglia, F. Barbanti, S. Castaldi, G. Fabio. - In: EUROPEAN JOURNAL OF INTERNAL MEDICINE. - ISSN 1879-0828. - (2018). [Epub ahead of print]
Abstract:
Objectives: To describe clinical characteristics and outcome of Clostridium difficile infection (CDI) patients in
Internal Medicine, to identify ribotypes (RTs); to evaluate the association between RT and patient clinical characteristics
and report outcome.
Methods: One year prospective cohort study. Clinical data, Barthel Index (BI) and outcomes were collected for all
inpatients suffering from CDI (n=148) in hospital wards in Northern Italy. 84 fecal samples were analysed for
molecular typing.
Results: 12 RTs were identified, predominantly RT018 (42.9%, n=36/84) and RT356/607 (40.5%, n=34/84).
Patients with dementia were more frequent among those infected by RT018 [55.6% (n=20/36) vs. 32.4%
(n=11/34), p=0.05]. The median BI score of patients with RT018 was lower than BI score of patients with
RT356/607 [10 (IQR 0–32) vs. 15 (IQR 5–50), p=0.06]. RT018 infection was associated to higher levels of C-reactive
protein [7.2mg/dl (IQR 4.1–14.7) vs. 4.0mg/dl (IQR 2.2–6.8), p=0.01] and white blood cells ≥15,000/
dl [33.3% (n=12/36) vs. 14.7% (n=5/34) of patients, p=0.07]. Higher mortality was noted among RT018
infected patients. We found a continuous mortality increase according to the ATLAS score.
Conclusions: Our results confirm that RT018 and RT356/607 are the two major RTs causing CDI in older patients
with a high degree of disability in Northern Italy and RT018 is associated with more serious outcomes.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
clostridium difficile infection; PCR-ribotype 018; PCR-ribotype 356/607; clinical outcomes; ATLAS score; Barthel index
Elenco autori:
S. Serafino, . Consonni, M. Migone De Amicis, F. Sisto, G. Domeniconi, S. Formica, M. Zarantonello, A. Maraschin, M.D. Cappellini, P. Spigaglia, F. Barbanti, S. Castaldi, G. Fabio
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