metricas
covid
Buscar en
Gastroenterología y Hepatología (English Edition)
Toda la web
Inicio Gastroenterología y Hepatología (English Edition) Case-control study of Clostridioides difficile in a rural health care area
Journal Information
Vol. 46. Issue 1.
Pages 1-9 (January 2023)
Share
Share
Download PDF
More article options
Visits
3
Vol. 46. Issue 1.
Pages 1-9 (January 2023)
Original article
Case-control study of Clostridioides difficile in a rural health care area
Estudio de casos-controles de la infección por Clostridioides difficile en un área sanitaria rural
Visits
3
Cristina Muñoz Cuevasa, María Ángeles Asencio Egeaa,
Corresponding author
marian_asencio@yahoo.es

Corresponding author.
, María Franco Huertab, María Huertas Vaqueroa, Ángel Arias Ariasc, Rafael Carranza Gonzáleza
a Laboratorio de Microbiología, Hospital General La Mancha Centro, Ciudad Real, Spain
b Servicio de Medicina Interna, Hospital General La Mancha Centro, Ciudad Real, Spain
c Unidad de Apoyo a la Investigación, Hospital General La Mancha Centro, Ciudad Real, Spain
This item has received
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Abstract
Objective

To determine the risk and prognostic factors for Clostridioides difficile infection (CDI).

Patients and methods

Prospective, case-control study with 61 cases and 64 controls, aged ≥ 2 years with diarrhoea, carried out in “Castilla-La Mancha” Health Care Area ​​for 14 months. The diagnosis was made by immunochromatography technics (glutamate dehydrogenase and toxin A/B), confirming discordant cases by isothermal amplification. Demographic variables, comorbidities, type of acquisition, previous administration of antibiotics, antacids and immunosuppressants, and evolution were collected. The data were analysed using the chi-square test and the effect of risk and prognostic factors was quantified using an odds ratio with 95% confidence intervals.

Results

Hospital admission 4 weeks prior to infection, hypoalbuminemia, and previous administration of antibiotics were identified as independent risk factors for CDI. Presenting these 3 factors constitutes nearly 3-fold increase in the risk of becoming infected. A greater number of hospital admissions in the 4−12 weeks prior to CDI were found in the group of nosocomial acquisition. Although there was a greater tendency to recurrence and an unfavourable prognosis among nosocomial cases, these differences were not significant. We found that fever and hospital admission in the 4 weeks prior to infection were unfavourable prognostic factors of CDI.

Conclusions

The independent risk factors for CDI were: hospital admission in the 4 weeks prior to infection, hypoalbuminemia, and previous administration of antibiotics. Fever and hospitalisation in the previous 4 weeks were also identified as prognostic factors of unfavourable evolution.

Keywords:
Clostridioides difficile infection
Antibiotic use
Case-control study
Risk factors
Prognostic factors
Resumen
Objetivo

Determinar los factores de riesgo y factores pronósticos de la infección por Clostridioides difficile (ICD).

Pacientes y métodos

Estudio prospectivo de casos-controles (61 casos y 64 controles) ≥2 años con diarrea, atendidos en un Área Sanitaria manchega durante 14 meses. El diagnóstico se realizó mediante inmunocromatografía (glutamato deshidrogenasa y toxina A/B), realizando amplificación isotérmica en los casos discordantes. Se recogieron variables demográficas, comorbilidades, tipo de adquisición, administración previa de antibióticos, antiácidos e inmunosupresores y evolución. Los datos se analizaron mediante la prueba de chi-cuadrado y el efecto de los factores de riesgo y pronósticos se cuantificó mediante odds ratio con intervalos de confianza del 95%.

Resultados

Como factores de riesgo independientes de ICD encontramos el ingreso hospitalario las 4 semanas previas a la infección, la hipoalbuminemia y la administración previa de antibióticos. Presentar estos 3 factores supuso un riesgo casi 3 veces mayor de infectarse. En el grupo de adquisición nosocomial se encontró mayor número de ingresos hospitalarios las 4−12 semanas previas a la ICD, y aunque hubo mayor tendencia a las recurrencias y pronóstico desfavorable entre los casos intrahospitalarios, estas diferencias no fueron significativas. Identificamos como factores de pronóstico desfavorable la fiebre y el ingreso hospitalario las 4 semanas previas a la infección.

Conclusiones

Los factores de riesgo independientes de ICD fueron: ingreso hospitalario las 4 semanas previas a la infección, hipoalbuminemia y administración previa de antibióticos. La fiebre y la hospitalización las 4 semanas anteriores se identificaron además como factores pronósticos de evolución desfavorable.

Palabras clave:
Infección por Clostridioides difficile
Consumo de antibióticos
Estudio de casos-controles
Factores de riesgo
Factores pronósticos

Article

These are the options to access the full texts of the publication Gastroenterología y Hepatología (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Gastroenterología y Hepatología (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos