Universität zu Köln

Aguilar, Rebeca Cruz, Salmanton-Garcia, Jon ORCID: 0000-0002-6766-8297, Carney, Jonathan, Boell, Boris, Kochanek, Matthias, Jazmati, Nathalie, Cornely, Oliver A. and Vehreschild, Maria J. G. T. (2020). Clostridioides difficile infections in the intensive care unit: a monocentric cohort study. Infection, 48 (3). S. 421 - 428. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1439-0973

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Abstract

Introduction Patient-level data from Clostridioides difficile infections (CDI) treated in an intensive care setting is limited, despite the growing medical and financial burden of CDI. Methods We retrospectively analyzed data from 100 medical intensive care unit patients at the University Hospital Cologne with respect to demography, diagnostics, severity scores, treatment, and outcome. To analyze factors influencing response to treatment and death, a backward-stepwise multiple logistic regression model was applied. Results Patients had significant comorbidities including 26% being immunocompromised. The mean Charlson Comorbidity Index was 6.3 (10-year survival rate of 2.25%). At the time of diagnosis, the APACHE II was 17.4 +/- 6.3 (predicted mortality rate of 25%), and the ATLAS score was 5.2 +/- 1.9 (predicted cure rate of 75%). Overall, 47% of CDI cases were severe, 35% were complicated, and 23% were both. At least one concomitant antibiotic was given to 74% of patients. The cure rate after 10 and 90 days was 56% and 51%, respectively. Each unit increment in APACHE II score was associated with poorer treatment response (OR 0.931; 95% CI 0.872-0.995; p = 0.034). Age above 65 years was associated with death (OR 2.533; 95% CI 1.031-6.221; p = 0.043), and overall mortality at 90 days was 56%. Conclusions CDI affects a high-risk population, in whom predictive scoring tools are not accurate, and outcomes are poor despite intensive treatment. Further research in this field is warranted to improve prediction scoring and patient outcomes.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Aguilar, Rebeca Cruz UNSPECIFIED UNSPECIFIED UNSPECIFIED Salmanton-Garcia, Jon UNSPECIFIED orcid.org/0000-0002-6766-8297 UNSPECIFIED Carney, Jonathan UNSPECIFIED UNSPECIFIED UNSPECIFIED Boell, Boris UNSPECIFIED UNSPECIFIED UNSPECIFIED Kochanek, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Jazmati, Nathalie UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Oliver A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, Maria J. G. T. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-340383
DOI:	10.1007/s15010-020-01413-8
Journal or Publication Title:	Infection
Volume:	48
Number:	3
Page Range:	S. 421 - 428
Date:	2020
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1439-0973
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EPIDEMIOLOGY; DISEASE; MORTALITY; UPDATE; MULTICENTER; AMERICA; SOCIETY; ADULTS Multiple languages Infectious Diseases Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/34038