Evaluation of advanced age as a risk factor for severe Clostridium difficile infection

Patel, Ursula; Wieczorkiewicz, Jeffrey T.; Tuazon, Jerry

doi:10.1016/j.jcgg.2015.06.003

Cited by 19 publications

(12 citation statements)

References 11 publications

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“…All of the present patients with CDI had a moderate form of disease, none requiring surgery and none died during hospitalization, findings in contrast to that reported in other studies, which found high mortality rates and high rates of severe forms of CDI in octogenarians . One possible explanation for our favorable outcomes might be the moderate disease, prompt diagnosis and treatment of infection.…”

Section: Discussioncontrasting

confidence: 83%

“…Life expectancy has increased over the past years in most countries, and the number of older adults with a high risk for CDI is also increasing . Several studies reported that in older adults, not only are CDI rates significantly higher than in younger age groups, but also elderly patients are at increased risk of adverse outcomes including mortality …”

Section: Introductionmentioning

confidence: 99%

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Clostridium difficile infection in hospitalized octogenarian patients

Trifan

Gîrleanu

Stanciu

et al. 2017

Geriatrics Gerontology Int

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Section: Discussioncontrasting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Clostridium difficile infection in hospitalized octogenarian patients

Trifan

Gîrleanu

Stanciu

et al. 2017

Geriatrics Gerontology Int

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“…There are many studies demonstrating old age as a risk factor for complicated C. difficile infection outcomes 8 , 11 – 13 . Patel et al 14 narrowed the age range to 70 or more years as severe CDI-risk-related and Khanna et al 4 showed that patients suffering from severely complicated infection were significantly older, with the median age of 80 years. In the study by Morrison RH et al, the analyses were limited to mortality alone and indicated independently significant associations between age ≥ 80 years and death, with an odds ratio of 5.5 15 .…”

Section: Discussionmentioning

confidence: 99%

Advanced age and increased CRP concentration are independent risk factors associated with Clostridioides difficile infection mortality

Bednarska

Bursa

Podlasin³

et al. 2020

Sci Rep

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Clostridioides difficile (C.difficile) is a Gram-positive, spore-forming, toxin-producing anaerobic bacillus, which is one of the most common causes of health-care-associated infection developed mainly by elderly patients. The objective of this study was to assess mortality among the patients of the Hospital for Infectious Diseases in Warsaw related to C.difficile infection. Analysis was conducted of 1638 records reporting the medical histories of patients hospitalized for the first time due to Clostridioides difficile infection (CDI) in the Hospital for Infectious Diseases in Warsaw from 2010 to 2017. The inclusion criteria were any (principal or secondary) discharge diagnosis code for CDI according to ICD-10 and being an adult (≥ 18 years). 108 out of 1638 (7%) of the patients died. The median age in this group was 83 years. The largest number of deaths (90%) occurred in the group of patients aged 65 years or older and 81–90 years old (53% of all the deaths). In the multivariate logistic regression model relevant only to the age groups, not to sepsis—age over 80 and over 90 were independent predictors of death, increasing the risk of death by 3.4 and 1.8 times, respectively. The result of the receiver operating curve (ROC) analysis determined the age of 77 years as the threshold value, indicating the increased risk of death (AUC 0.727, standard error 0.025, 95% CI 0.678–0.776, p < 0.0001). In addition, other quantitative variables, namely CRP, creatinine and leucocytes were studied and turned out to be independent death predictors as well. The diagnosis of sepsis increased the risk of death fourfold (OR = 4.042; 95% Cl 2.4–6.7; p < 0.001). Increased inflammatory parameters, namely CRP and white blood cell count, advanced age, particularly over the age of 80, as well as a diagnosis of sepsis are independent risk factors for death and could be used as predictive markers of poor outcome in CDI.

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“…However, the level of infection was neither studied nor evaluated deeply. Old age individuals are more susceptible to Clostridium defficile infection because it is related to their humoral immune response (Patel, Wieczorkiewicz, & Tuazon, 2016). In addition, CDAD infection often happens at an old age where, in the health care setting, they have consumed broad spectrum antibiotic (Allen et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Lactobacillus sp as a Probiotic for the Prevention of Clostridium difficile Associated Diarrhea

Rohmah

Andini

Luawo

et al. 2020

J. Ners

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Background: Antibiotic treatment can disturb the resistance of the gastrointestinal flora to colonization. This may result in complications, the most serious of which is Clostridium difficile associated diarrhea (CDAD). The aim of this study was to determine the effectiveness of probiotics for the prevention of CDAD.Method: The databases used were Scopus, Proquest, CINAHL, Medline, Pubmed and ScienceDirect, limited to having been published in the last 5 years. A literature review followed the keyword search. The keywords used were probiotics, Clostridium difficile, associated, diarrhea, randomized, control and trial using "AND" and “OR”. Twelve trials with 5102 participants were included. Eight trials reported a preventive effect for CDAD using a mixture of 2 strains of lactobacillus, a mixture of 4 combination strains, a mixture of lactobacillus and Saccharomyces or a mixture of Biﬁdobacterium, Lactobacillus and Saccharomyces.Result: Our findings indicate that probiotics may prevent CDAD. Most probiotics contain a singular strain. The combination with lactobacillus sp was the most effective at preventing CDAD.Conclusion: In addition, 6 out of 8 trials had an in relation to preventing CDAD containing lactobacillus sp. Four studies said that there were some factors that meant that the probiotic could not reduce or prevent the CDAD.

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Evaluation of advanced age as a risk factor for severe Clostridium difficile infection

Cited by 19 publications

References 11 publications

Clostridium difficile infection in hospitalized octogenarian patients

Clostridium difficile infection in hospitalized octogenarian patients

Advanced age and increased CRP concentration are independent risk factors associated with Clostridioides difficile infection mortality

Lactobacillus sp as a Probiotic for the Prevention of Clostridium difficile Associated Diarrhea

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