Hospital-acquired Clostridium difficile disease in ICU patients
Author Information
Author(s): Marra Alexandre R, Edmond Michael B, Wenzel Richard P, Bearman Gonzalo ML
Primary Institution: Virginia Commonwealth University
Hypothesis
What is the epidemiology, clinical course, and outcome of hospital-acquired Clostridium difficile-associated disease in the ICU setting?
Conclusion
In ICU patients with CDAD, advanced age and increased severity of illness at the onset of infection are independent predictors of death.
Supporting Evidence
- 62% of patients had concurrent infections, with 50% being bloodstream infections.
- In-hospital mortality was 27.6%.
- SOFA score and age were independent predictors of mortality.
Takeaway
Clostridium difficile is a serious infection that can happen in hospitals, especially in older patients who are very sick. It can lead to a lot of complications and even death.
Methodology
A historical cohort study was performed on 58 adults with a positive C. difficile cytotoxin assay result occurring in intensive care units.
Potential Biases
The study lacked controls and did not investigate risk factors for developing CDAD.
Limitations
The study was retrospective, limited to hospitalized patients, and had a small sample size, which may affect generalizability.
Participant Demographics
The median age was 55.5 years, with 37.9% of patients over 60 years old; 60.3% were male.
Statistical Information
P-Value
0.002 for SOFA score, 0.011 for age
Confidence Interval
CI95 1.13–1.75 for SOFA score, CI95 1.02–1.19 for age
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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