Abstract:
BACKGROUND:Clostridium difficile-associated disease (CDAD) is a serious nosocomial infection, however few studies have assessed CDAD outcome in the intensive care unit (ICU). We evaluated the epidemiology, clinical course and outcome of hospital-acquired CDAD in the critical care setting. METHODS:We performed a historical cohort study on 58 adults with a positive C. difficile cytotoxin assay result occurring in intensive care units. RESULTS:Sixty-two percent of patients had concurrent infections, 50% of which were bloodstream infections. The most frequently prescribed antimicrobials prior to CDAD were anti-anaerobic agents (60.3%). Septic shock occurred in 32.8% of CDAD patients. The in-hospital mortality was 27.6%. Univariate analysis revealed that SOFA score, at least one organ failure and age were predictors of mortality. Charlson score >/=3, gender, concurrent infection, and number of days with diarrhea before a positive C. difficile toxin assay were not significant predictors of mortality on univariate analysis. Independent predictors for death were SOFA score at infection onset (per 1-point increment, OR 1.40; CI95 1.13-1.75) and age (per 1-year increment, OR 1.10; CI95 1.02-1.19). CONCLUSION:In ICU patients with CDAD, advanced age and increased severity of illness at the onset of infection, as measured by the SOFA score, are independent predictors of death.
journal_name
BMC Infect Disjournal_title
BMC infectious diseasesauthors
Marra AR,Edmond MB,Wenzel RP,Bearman GMdoi
10.1186/1471-2334-7-42subject
Has Abstractpub_date
2007-05-21 00:00:00pages
42issn
1471-2334pii
1471-2334-7-42journal_volume
7pub_type
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