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Culturing and Maintaining Clostridium difficile in an Anaerobic Environment
Published on: September 14, 2013
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Clostridioides difficile infection in mechanically ventilated critically ill patients: A nested cohort study
Joanna C Dionne1, Jennie Johnstone2, Diane Heels-Ansdell3
1Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Farncombe Family Digestive Health Research Institute, McMaster University Hamilton, Ontario, Canada; Department of Health Research Methods, Evaluation and Impact, McMaster University, Canada.
Journal of Critical Care
|January 22, 2023
Summary
Clostridioides difficile infection (CDI) was uncommon in critically ill patients, with mild to moderate severity and no association with mortality. However, CDI did lead to a longer hospital stay.
Area of Science:
- Critical care medicine
- Infectious diseases
- Epidemiology
Background:
- Clostridioides difficile infection (CDI) is a significant concern in critically ill patients.
- Understanding the epidemiology and outcomes of CDI is crucial for patient management.
Purpose of the Study:
- To determine the incidence, prevalence, timing, severity, predictors, and outcomes of Clostridioides difficile infection (CDI) in critically ill patients.
- To assess the impact of CDI on patient outcomes, including mortality and hospital stay duration.
Main Methods:
- A prospective nested cohort study was conducted within a randomized trial comparing Lactobacillus rhamnosus GG to placebo.
- Cases of CDI were adjudicated using standardized definitions, and timing, severity, risk factors, and outcomes were analyzed.
Main Results:
- The incidence of CDI was 0.95 per 1000 hospital-days, with a prevalence of 3.2%.
- CDI occurred at various times: 0.3% pre-ICU, 2.2% in the ICU, and 0.8% post-ICU. Relapse or recurrence was observed in 9.3% of patients.
- Infections were generally mild to moderate, with complications like septic shock (26.7%) and organ failure (16.3%). No significant risk factors were identified, and CDI was not associated with hospital mortality.
Conclusions:
- Clostridioides difficile infection (CDI) is uncommon in critically ill patients and typically presents with mild to moderate severity.
- While not associated with increased hospital mortality, CDI was linked to a significantly longer duration of hospital stay.
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