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

Data de publicació: 01/04/2018 Data Ahead of Print: 06/03/2017

Autors de IIS La Fe

Miguel Angel Chiveli Monleon

Autor

Autors aliens a IIS La Fe

Gutierrez-Pizarraya, A
Martin-Villen, L
Alcala-Hernandez, L
Marín Arriaza M
Balandin-Moreno, B
Aragon-Gonzalez, C
Ferreres-Franco, J
Anguita-Alonso, P
Bouza-Santiago, E
Garnacho-Montero, J

Abstract

Introduction: Our objectives were to describe the incidence, clinical characteristics, and risk factors for Clostridium difficile infection (CDI) in critically ill patients and to determine C. difficile PCR-ribotypes. Methods: Prospective, observational study in 26 Spanish ICUs. Patients with diarrhea meeting ESCMID criteria for CDI were included. Molecular characterization of isolates was performed using PCR ribotyping. Results: Of 4258 patients admitted to the ICUs, 190 (4.5%) developed diarrhea. Only 16 patients (8.4%) were diagnosed with CDI. Ribotype 078/126 (25.0%) was the most frequently identified. The mortality rate was similar in patients with ICD compared to patients with diarrhea not caused by C. difficile (p = 0.115). Chronic renal insufficiency was identified as the only factor independently associated with the development of CDI (OR 5.87, 95% CI 1.24-27.83; p = 0.026). Conclusions: The incidence of CDI in Spanish ICUs is low. Only chronic renal insufficiency was observed to be a risk factor for CDI development. (C) 2017 Elsevier Espana, S.L.U. and Sociedad Espanola de Enfermedades Infecciosas y Microbiologia Clinica. All rights reserved.

Dades de la publicació

ISSN/ISSNe:: 0213-005X, 1578-1852
Tipus:: Article
Pàgines:: 218-221
DOI:: 10.1016/j.eimc.2017.01.007
PubMed:: 28279489
Factor d'Impacte:: 0,348 SCImago ℠
Quartil:: Q3 SCImago ℠

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Filiacions

Gutierrez-Pizarraya, A:: Instituto de Biomedicina de Sevilla, IBIS/Hospitales Universitarios Virgen Macarena - Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain

Univ Seville, Hosp Univ Virgen Macarena Virgen del Rocio, CSIC, Inst Biomed Sevilla,IBIS, Seville, Spain
Martin-Villen, L:: Unidad Clínica de Cuidados Intensivos, Hospital Virgen del Rocío, Sevilla, Spain

Hosp Virgen del Rocio, Unidad Clin Cuidados Intens, Seville, Spain
Alcala-Hernandez, L:: Microbiology Department, H. Universitario Gregorio Marañón, Madrid, Spain

Department of Medicine, Universidad Complutense, IISGM and CIBERES, Spain

H Univ Gregorio Maranon, Microbiol Dept, Madrid, Spain

Univ Complutense, IISGM, Dept Med, Madrid, Spain

CIBERES, Madrid, Spain
Marín Arriaza M:: Microbiology Department, H. Universitario Gregorio Marañón, Madrid, Spain

Department of Medicine, Universidad Complutense, IISGM and CIBERES, Spain
Balandin-Moreno, B:: Intensive Medicine Department, H. Puerta de Hierro, Madrid, Spain

H Puerta Hierro, Intens Med Dept, Madrid, Spain
Aragon-Gonzalez, C:: Unidad Clínica de Cuidados Intensivos, H. General Carlos Haya, Málaga, Spain

H Gen Carlos Haya, Unidad Clin Cuidados Intens, Malaga, Spain
Ferreres-Franco, J:: Intensive Medicine Department, H. Clínico Universitario, Valencia, Spain

H Clin Univ, Intens Med Dept, Valencia, Spain
Chiveli Monleón MÁ:: Anaesthesia and Reanimation Department, H. Universitario La Fe, Valencia, Spain
Anguita-Alonso, P:: Astellas Pharma S.A., Spain

Astellas Pharma SA, Madrid, Spain
Bouza-Santiago, E:: Microbiology Department, H. Universitario Gregorio Marañón, Madrid, Spain

Department of Medicine, Universidad Complutense, IISGM and CIBERES, Spain

H Univ Gregorio Maranon, Microbiol Dept, Madrid, Spain

Univ Complutense, IISGM, Dept Med, Madrid, Spain

CIBERES, Madrid, Spain
Garnacho-Montero, J:: Unidad Clínica de Cuidados Intensivos, Hospital Universitario Virgen Macarena, Sevilla, Spain

Instituto Biomedicina, Sevilla, Spain

Hosp Univ Virgen Macarena, Unidad Clin Cuidados Intens, Seville, Spain

Inst Biomed, Seville, Spain