<i>Clostridium difficile</i> infection in hospitalized octogenarian patients

Trifan, Anca; Gîrleanu, Irina; Stanciu, C; Miftode, Egidia; Cojocariu, Camelia; Sîngeap, Ana-Maria; Sfarti, Cătălin; Chiriac, Ştefan; Cuciureanu, Tudor; Stoica, Oana

doi:10.1111/ggi.13186

Cited by 8 publications

(8 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, the EUCLID study reported the prevalence of ribotype 027 strains to be among the highest in Europe in Romania [2] and a recent study performed in tertiary centers from 6 cities in different areas from Romania identified a mean prevalence of 5.2 cases per 10,000 patient days, with the highest prevalence of PCR ribotype 027 of 82.6%, values which are higher compared to the one previously reported [3]. Specific patients' category are at a higher risk for CDI, with a recent study performed in two tertiary centers in Romania highlighting a 27.6% rate of CDI in octogenarian patients [4]. Considering this epidemiological data, it is important to expand the therapeutic options, especially if we further take into account that 15.2% of patients experience recurrence within 8 weeks from the initial episode of CDI, while for patients with previous recurrences, the risk further increases up to 40.6% [5,6].…”

Section: Rationale Of the National Guideline T H E E P I D E M I O L mentioning

confidence: 81%

“…Considering some particular patient-related aspects of CDI infection in potential FMT recipients in Romania, such as increased age [4] and also the prevalence of ribotype 027 [3], the working group discussed the opportunity for the use of FMT among patients with one CDI recurrence and risk factors for other recurrences. We considered the risk factors identified in literature, namely antibiotics use for non-C. difficile after CDI diagnosis, long term gastric acid suppression, severe underlying disease and/or renal insufficiency/ severe illness by Horn index, previous severe CDI, prolonged hospital stays, severe underlying disease and/or renal insufficiency, a history of previous CDI, previous CDI severity, prolonged hospital stay hypervirulent strain, NAP1/BI/027 [39,40].…”

Section: Which Patients With CDI Should Be Considered For Fmt?mentioning

confidence: 99%

See 1 more Smart Citation

Romanian National Guideline on Translating Fecal Microbiota Transplantation Applications related to Clostridioides difficile Infections into the Local Clinical Practice

Gîlcă-Blanariu

Ştefănescu

Gîrleanu

et al. 2021

JGLD

Self Cite

View full text Add to dashboard Cite

Fecal microbiota transplantation involves the infusion of intestinal microorganisms via the transfer of a stool from a healthy individual into a diseased individual, with the intent of restoring normal intestinal flora. Fecal transplant is proposed for the treatment of refractory Clostridioides difficile infection. At present, recurrent Clostridioides difficile infection is the only indication supported by solid scientific evidence. Regulations by healthcare authorities vary among different countries. Considering that Romania does not have an available national guideline to offer standardization, this paper aimed to create a national fecal microbiota transplantation guideline concerning indications, techniques and donor screening, developed by international and local scientific working groups.

show abstract

Section: Rationale Of the National Guideline T H E E P I D E M I O L mentioning

confidence: 81%

Section: Which Patients With CDI Should Be Considered For Fmt?mentioning

confidence: 99%

Romanian National Guideline on Translating Fecal Microbiota Transplantation Applications related to Clostridioides difficile Infections into the Local Clinical Practice

Gîlcă-Blanariu

Ştefănescu

Gîrleanu

et al. 2021

JGLD

Self Cite

View full text Add to dashboard Cite

show abstract

“…Although the majority of the literature on the epidemiologic features of CDI is based on the association of antibiotic therapy and hospitalization settings[ 17 , 24 - 26 ], some other potential risk factors for CDI, such as advanced age, immunosuppression, comorbidities, chemotherapy, renal insufficiency, hypoalbuminemia, organ transplantation and use of proton pump inhibitors, have been identified to explain the increased incidence of CDI[ 7 , 21 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although CDI can affect individuals of all ages, the elderly are recognized as high-risk for this infection[ 17 , 27 ]. Older patients represent a vulnerable population for CDI because they often have multiple comorbidities, have frequent and prolonged hospitalizations, receive broad-spectrum antibiotics, and have altered host defense against infections[ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Did the severe acute respiratory syndrome-coronavirus 2 pandemic cause an endemic Clostridium difficile infection?

Cojocariu¹,

Gîrleanu²,

Trifan³

et al. 2021

WJCC

Self Cite

View full text Add to dashboard Cite

BACKGROUND Clostridium difficile infection (CDI) has increased in prevalence during the last years. The coronavirus disease 2019 (COVID-19) pandemic has negatively influenced patient outcomes. The majority of the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2)-infected patients received antibiotics during hospitalization. AIM To analyze the factors that influenced CDI development after SARS-CoV-2 infection. METHODS Between March 2020 to December 2020, we performed a prospective observational study including 447 patients diagnosed with CDI who were admitted to our tertiary referral university hospital. The diagnosis of CDI was based on the presence of diarrhea (≥ 3 watery stools within 24 h) associated with Clostridium difficile toxins A or B. We excluded patients with other etiology of acute diarrhea. RESULTS Among the total 447 (12.5%) patients with CDI, most were male (54.3%) and mean age was 59.7 ± 10.8 years. Seventy-six (17.0%) had history of COVID-19, most being elderly (COVID-19: 62.6 ± 14.6 years vs non-COVID-19: 56.8 ± 17.6 years, P = 0.007), with history of alcohol consumption (43.4% vs 29.4%, P = 0.017), previous hospitalizations (81.6% vs 54.9%, P < 0.001) and antibiotic treatments (60.5% vs 35.5%, P < 0.001), requiring higher doses of vancomycin and prone to recurrent disease (25.0% vs 13.1%, P = 0.011). Age over 60 years [odds ratio (OR): 2.591, 95% confidence interval (CI): 1.452-4.624, P = 0.001], urban residence (OR: 2.330, 95%CI: 1.286-4.221, P = 0.005), previous antibiotic treatments (OR: 1.909, 95%CI: 1.083-3.365, P = 0.025), previous hospitalizations (OR: 2.509, 95%CI: 1.263-4.986, P = 0.009) and alcohol consumption (OR: 2.550, 95%CI: 1.459-4.459, P = 0.001) were risk factors of CDI in COVID-19. CONCLUSION CDI risk is unrelated to history of SARS-CoV-2 infection. However, previous COVID-19 may necessitate higher doses of vancomycin for CDI.

show abstract

“…Through the current literatures, the patients' average age usually in range of 55-56 year old [2,3,4]. Due to the aged people especially like octogenarian is susceptible to infection [5], it might be refer that there will be tremendous number of aged people suffered from COVID-19 pneumonia. It should not neglect the octogenarian group in the current virus storm.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Clinical Features in Octogenarian and Non-octogenarian Adults with Severe COVID-19 Pneumonia

Shu

Liu

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Aged people is more susceptible and vulnerable to COVID-19 pneumonia. As the “super-elderly” group, octogenarian COVID-19 patients is not rare in current world-wide common healthy event.Object: To describe clinical features in octogenarian with severe COVID-19. And try to find out the differences with other non-octogenarian adult patients.Materials and Methods: We studied a small cohort of octogenarian COVID-19 patients at a hospital in Wuhan from 10 February to 15 March. We recorded interested clinical data including chest CT in the octogenarian patients. In order to know the differences of clinical characteristics between octogenarian and other adult patients, we included the number of non-octogenarian patients cohort as ratio of 1:3.Result: For octogenarian patients, the age is 83.33±3.08 and 4 are female (4/6,66.7%). For non-octogenarian patients, the age is 60.72±8.28 years and 5 are female(5/18, 27.8%). and 59% were men. Compared non-octogenarian patients, octogenarian patients’ hospital stay duration is significantly longer (p=0.0052*). WBC is obvious elevated in octogenarian(p=0.0494*). BUN (p=0.0377*) and Cr (p=0.0112*) is with obvious differences between two group patients. No obvious differences in CT findings between two groups.Conclusion: The severe COVID-19 pneumonia octogenarian may have more chance to combined with bacterial infection. Octogenarian has worse baseline kidney function than non-octogenarian. In individual cases, the broader lesion and more lesion types may be found in octogenarian CT image.

show abstract

Clostridium difficile infection in hospitalized octogenarian patients

Abstract: Hospitalized octogenarians with comorbidities, recently hospitalized or receiving antibiotic treatment are at risk for C. difficile infection. Clinicians evaluating such patients should have a high index of suspicion for this infection. Geriatr Gerontol Int 2018; 18: 315-320.

Cited by 8 publications

References 27 publications

Romanian National Guideline on Translating Fecal Microbiota Transplantation Applications related to Clostridioides difficile Infections into the Local Clinical Practice

Romanian National Guideline on Translating Fecal Microbiota Transplantation Applications related to Clostridioides difficile Infections into the Local Clinical Practice

Did the severe acute respiratory syndrome-coronavirus 2 pandemic cause an endemic Clostridium difficile infection?

Comparison of Clinical Features in Octogenarian and Non-octogenarian Adults with Severe COVID-19 Pneumonia

Contact Info

Product

Resources

About