Epidemiology and risk factors for Clostridium difficile infection in critically ill patients in Spain: The PROCRID study

2018 ◽  
Vol 36 (4) ◽  
pp. 218-221
Author(s):  
Antonio Gutiérrez-Pizarraya ◽  
Luis Martín-Villén ◽  
Luis Alcalá-Hernández ◽  
Mercedes Marín Arriaza ◽  
Bárbara Balandín-Moreno ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Critically Ill ◽  
Clostridium Difficile Infection ◽  
Critically Ill Patients

Epidemiology and risk factors for Clostridium difficile infection in critically ill patients in Spain: The PROCRID study

2018 ◽  
Vol 36 (4) ◽  
pp. 218-221 ◽  
Author(s):  
Antonio Gutiérrez-Pizarraya ◽  
Luis Martín-Villén ◽  
Luis Alcalá-Hernández ◽  
Mercedes Marín Arriaza ◽  
Bárbara Balandín-Moreno ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Critically Ill ◽  
Clostridium Difficile Infection ◽  
Critically Ill Patients

scholarly journals Prolonged Mechanical Ventilation Assistance Interacts Synergistically with Carbapenem for Clostridium difficile Infection in Critically Ill Patients

2018 ◽  
Vol 7 (8) ◽  
pp. 224 ◽  
Author(s):  
Shyh-Ren Chiang ◽  
Chih-Cheng Lai ◽  
Chung-Han Ho ◽  
Chin-Ming Chen ◽  
Chien-Ming Chao ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Clostridium Difficile ◽  
Critically Ill ◽  
Clostridium Difficile Infection ◽  
Critically Ill Patients ◽  
Prolonged Mechanical Ventilation ◽  
Comorbidity Scores ◽  
Independent Risk Factors ◽  
High Comorbidity

Objectives: Interactions between mechanical ventilation (MV) and carbapenem interventions were investigated for the risk of Clostridium difficile infection (CDI) in critically ill patients undergoing concurrent carbapenem therapy. Methods: Taiwan’s National Intensive Care Unit Database (NICUD) was used in this analytical, observational, and retrospective study. We analyzed 267,871 intubated patients in subgroups based on the duration of MV support: 7–14 days (n = 97,525), 15–21 days (n = 52,068), 22–28 days (n = 35,264), and 29–60 days (n = 70,021). The primary outcome was CDI. Results: Age (>75 years old), prolonged MV assistance (>21 days), carbapenem therapy (>15 days), and high comorbidity scores were identified as independent risk factors for developing CDI. CDI risk increased with longer MV support. The highest rate of CDI was in the MV 29–60 days subgroup (adjusted hazard ratio (AHR) = 2.85; 95% confidence interval (CI) = 1.46–5.58; p < 0.02). Moreover, higher CDI rates correlated with the interaction between MV and carbapenem interventions; these CDI risks were increased in the MV 15–21 days (AHR = 2.58; 95% CI = 1.12–5.91) and MV 29–60 days (AHR = 4.63; 95% CI = 1.14–10.03) subgroups than in the non-MV and non-carbapenem subgroups. Conclusions: Both MV support and carbapenem interventions significantly increase the risk that critically ill patients will develop CDI. Moreover, prolonged MV support and carbapenem therapy synergistically induce CDI. These findings provide new insights into the role of MV support in the development of CDI.

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