| アブストラクト | BACKGROUND: Clostridioides difficile infection (CDI) increases the risk of complications and mortality. We assessed the magnitude of these outcomes in a large cohort of English patients with initial and recurrent CDI. AIM: To compare the risk of complications and all-cause mortality, within 12 months, among hospitalized patients >/=18 years old with hospital-associated- (HA-) CDI and recurrent CDI. METHODS: Patients with HA-CDI during 2002-2013 were identified using inpatient hospital data linked to primary care and death data. Each HA-CDI case was frequency matched to two hospitalized patients without CDI on age group, sex, calendar year of admission, admission method and number of hospital care episodes. A second CDI episode starting on days 13-56 was defined as recurrence. Risks of mortality and complications at 12 months were analysed using Cox proportional hazard models. FINDINGS: We included 6862 patients with HA-CDI and 13,724 without CDI. Median age was 81.0 years (IQR 71.0-87.0). Patients with HA-CDI had more comorbidities than those without CDI, and significantly higher risks of mortality (adjusted hazard ratio (95% confidence interval) 1.77 (1.67-1.87)) and complications (1.66 (1.46-1.88)) within 12 months from hospital admission. Of those with HA-CDI, 1140 (16.6%) experienced CDI recurrence. Patients with recurrent versus non-recurrent CDI also had significantly increased risk of mortality (1.32 (1.20-1.45)) and complications (1.37 (1.01-1.84)) in the 12 months from the initial CDI. CONCLUSIONS: HA-CDI (versus no CDI) and recurrent CDI are both associated with significantly higher risks of complications or death within 12 months of the initial CDI episode. |
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| ジャーナル名 | The Journal of hospital infection |
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| Pubmed追加日 | 2020/9/29 |
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| 投稿者 | Enoch, D A; Murray-Thomas, T; Adomakoh, N; Dedman, D; Georgopali, A; Francis, N A; Karas, A |
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| 組織名 | Public Health England, Addenbrooke's Hospital, Cambridge, UK. Electronic address:;david.enoch@addenbrookes.nhs.uk.;Clinical Practice Research Datalink, London, UK.;Astellas Pharma Europe Ltd, Addlestone, UK.;Division of Population Medicine, Cardiff University, Cardiff, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/32987118/ |
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