scholarly journals Predictors associated with failure of metronidazole in treatment of clostridium difficile infection in the elderly

2014 ◽  
Vol 67 (suppl. 2) ◽  
pp. 18-23
Author(s):  
Nadica Kovacevic ◽  
Grozdana Canak ◽  
Tomislav Preveden ◽  
Slavica Tomic ◽  
Vedrana Petric ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Treatment Failure ◽  
Clostridium Difficile Infection ◽  
Clinical Symptoms ◽  
Concomitant Administration ◽  
The Elderly ◽  
Albumin Level ◽  
Nosocomial Diarrhea ◽  
Clinical Center

Introduction. Clostridium difficile is the most common infectious cause of nosocomial diarrhea. Recommended treatments for Clostridium difficile infection include metronidazole and vancomycin. Recent investigation has shown an increasing rate of metronidazole treatment failure, particularly among the elderly. The authors studied the outcome of metronidazole therapy for Clostridium difficile infection in patients over 65 years of age and risk factors associated with metronidazole treatment failure. Material and Methods. This retrospective study was performed at the Department of Infectious Diseases, Clinical Center of Vojvodina from January 2011 to January 2014. The study sample included 112 patients, over 65 years of age, diagnosed with Clostridium difficile infection, who were treated with oral metronidazole 400 mg 3 times per day for 10 days. The efficacy of treatment regimen was assessed by resolution of diarrhea and rates of recurrence within 60 days after completion of therapy Results. Metronidazole was administrated to 112 patients over 65 years of age. Treatment with metronidazole resulted in resolution of diarrhea in 78 patients (69.65%). After successful metronidazole treatment, clinical symptoms of Clostridium difficile infection recurred in 28 the patients (36.60%) . Risk factors for metronidazole treatment failure are duration of diarrhea before treatment, leucocytosis >15 000/mm3, albumin level ?25 g/l, serum creatinine level ?200 ?mol/l, increased C-reactive protein, and concomitant administration of antibiotic and immunosuppressives. Conclusion. Our data suggest that patients with predictors of metronidazole treatment failure may benefit from initial oral vancomycin therapy for Clostridium difficile infection.

scholarly journals Clinical characterization and risk factors of Clostridium difficile infection in elderly patients in a Chinese hospital

2015 ◽  
Vol 9 (04) ◽  
pp. 381-387 ◽  
Author(s):  
Zhang Lihua ◽  
Dong Danfeng ◽  
Jiang Cen ◽  
Wang Xuefeng ◽  
Peng Yibing
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Elderly Patients ◽  
Clinical Features ◽  
Clostridium Difficile Infection ◽  
Gastrointestinal Disease ◽  
Statistical Tests ◽  
The Elderly ◽  
Hospitalized Patients ◽  
Elderly Hospitalized Patients

Introduction: Clostridium difficile is a common cause of nosocomial diarrhea, especially in elderly patients. This study aimed to analyze the clinical features and assess the risk factors associated with Clostridium difficile infection (CDI) in elderly hospitalized patients. Methodology: A retrospective case-control study was conducted among elderly hospitalized patients (> 60 years of age) in a Chinese tertiary hospital between 2010 and 2013. Fifty-two CDI patients and 150 randomly selected non-CDI patients were included in the study. Clinical features of CDI and non-CDI patients were compared by appropriate statistical tests. Logistic regression analyses were performed on a series of factors to determine the risk factors for CDI among the elderly hospitalized patients. Results: The elderly CDI patients showed higher leukocyte counts, lower serum albumin levels, longer duration of hospital stay, and higher mortality compared to the non-CDI patients. The proportion of patients admitted to the intensive care unit or exposed to gastric acid suppressants was also significantly different (p < 0.05) between the two groups. Multivariate analysis indicated that serum creatinine (OR 1.004; 95% CI 1.001–1.008), surgical intervention (OR 6.132; 95% CI 2.594–14.493), the number of comorbidities (OR 2.573; 95% CI 1.353–4.892), gastrointestinal disease (OR 4.670; 95% CI 2.002–10.895), and antibiotic use (OR 6.718; 95% CI 2.846–15.859) were independently associated with CDI. Conclusions: This study revealed several risk factors for CDI among elderly hospitalized patients. These findings will increase the knowledge concerning this disease and provide information regarding the control and prevention of CDI in the elderly.

scholarly journals Risk factors for recurrent Clostridium difficile infection among patients in the Clinical Centre of Vojvodina, Serbia: A retrospective clinical trial

2019 ◽  
Vol 76 (4) ◽  
pp. 392-397
Author(s):  
Nadica Kovacevic ◽  
Radoslava Doder ◽  
Tomislav Preveden ◽  
Maria Pete
Keyword(s):  
Risk Factors ◽  
Clinical Trial ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Recurrent Clostridium Difficile Infection ◽  
Clinical Center ◽  
End Of Treatment ◽  
Clinical Centre ◽  
Oral Metronidazole

Background/Aim. In the last two decades the incidence of recurrent Clostridium difficile infection (CDI) has risen. The aim of this study was to determine the risk factors for the recurrent CDI among patients hospitalized with the initial CDI. Methods. We conducted a retrospective clinical trial at the Clinic for Infectious Diseases, Clinical Center of Vojvodina, Serbia, between January 2010 and January 2016. We enrolled 488 patients with the initial CDI who were treated with oral vancomycin (125 mg, 4 times per day) or oral metronidazole (400 mg, 3 times per day) for 10 days. After the completion of therapy, there was 60 days of the follow-up period for the assessment of the rates of relapse. To determine the risk factors for the CDI relapse, we compared the demographics, clinical and laboratory characteristics of the patients who had a relapse with the patients who had a stable clinical response. Results. Of the 488 cases, 29.09% recurred. The relapse occured in 22.72% patients who received vancomycin and in 36.60% patients treated with metronidazole (p = 0.038). A statistically significant effect on the CDI relapse had the comorbidities such as a malignancies (19.52% vs 8.82%, p = 0.023) and the postoperative CDI (25.67% vs 10.29%, p = 0.035), hipoalbuminemia (< 25 g/L) (70.27% vs 41.94%; p = 0.034) and the concomitant antibiotic therapy (50.67% vs 20.29%; p = 0.031). The persistence of C. difficile toxin in the stool at the end of treatment was registered in 22.32% of patients treated with metronidazole vs 9.09% of patients given vancomycin (p = 0.03). Conclusion. Our data suggest that the important risk factors for the CDI relapse are comorbidities (surgery within a month before developing CDI and malignancy), hipoalbuminemia (< 25g/L) and concomitant non-CDI antibiotics therapy. Vancomycin is more effective than metronidazole in the elimination of C. difficile toxins. The presence of C. difficile toxins in the stool after the successful completion of the initial CDI therapy does not affect significantly the occurrence of relapse.

scholarly journals The effect of the infection Clostridium difficile on the rehabilitation

2014 ◽  
Vol 4 (1) ◽  
pp. 55-58
Author(s):  
Edina Tanovic ◽  
Haris Tanovic ◽  
Aldijana Kadic ◽  
Dževad Vrabac ◽  
Senad Selimović ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Barthel Index ◽  
Rank Test ◽  
Nosocomial Diarrhea ◽  
Clinical Center ◽  
Signed Rank ◽  
Signed Rank Test ◽  
Kolmogorov Smirnov ◽  
The Impact

Introduction: Clostridium difficile is the cause of the post antibiotic colitis. This anaerobe, sporogenous, gram-positive bacteria is most often recognized as the cause of the nosocomial diarrhea. The aim of this work is to show the impact of the infection Clostridium difficile on the result of rehabilitation of the patients that have been treated in the rehabilitation facility.Methods: 448 patients treated at the Clinic for physical medicine and rehabilitation of the Clinical Center University of Sarajevo were included in the study. Gender, age, Barthel index, length of hospitalization, and values of the albumin in the serum were documented. Kolmogorov-Smirnov test, Mann-Whitney U test and One Sample Wilcoxon Signed Rank test were used for data analysis.Results: There were 57% female and 43% of male patients. The average age was 67.5 years for women and 52 years for men. Barthel index at admission was 4.0 and at discharge raised to 8.0 (p=0.047). The length of the hospitalization for patients without infection was shorter (28.8 days) compared to patients with infection (43 days) (p=0.015). Values of the albumin in the blood at patients with confirmed Clostridium difficile infection were significantly lower than referent values (p = 0.016).Conclusion: Patients with Clostridium difficile infection had longer period of the rehabilitation and the results were less favorable.

P196: Clostridium difficile infection – serious problem for the elderly?

2014 ◽  
Vol 5 ◽  
pp. S145-S146
Author(s):  
K. Bielakova ◽  
H. Matejovská-Kubešová ◽  
P. Weber ◽  
D. Weberová
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
The Elderly

Risk Factors and Outcomes Associated With Severe Clostridium difficile Infection in Children

2012 ◽  
Vol 31 (2) ◽  
pp. 134-138 ◽  
Author(s):  
Jason Kim ◽  
Julia F. Shaklee ◽  
Sarah Smathers ◽  
Priya Prasad ◽  
Lindsey Asti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Severe Clostridium Difficile Infection

Risk Factors for Recurrence of Clostridium Difficile-associated Diarrhea in the Elderly

2002 ◽  
Vol 34 (8) ◽  
pp. 594-597 ◽  
Author(s):  
Sari Tal ◽  
Alexander Gurevich ◽  
Vladimir Guller ◽  
Irina Gurevich ◽  
David Berger ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
The Elderly ◽  
Risk Factors For Recurrence ◽  
Clostridium Difficile Associated Diarrhea

835 Genetic Risk Factors for Clostridium difficile Infection in Ulcerative Colitis

2013 ◽  
Vol 144 (5) ◽  
pp. S-148
Author(s):  
Ashwin N. Ananthakrishnan ◽  
Emily Oxford ◽  
Deanna D. Nguyen ◽  
Jenny Sauk ◽  
Vijay Yajnik ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ulcerative Colitis ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Genetic Risk ◽  
Genetic Risk Factors
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