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Clostridioides difficile Infections and Factors Associated with Recurrence
1Department of Infectious Diseases and Clinical Microbiology, Giresun University School of Medicine, Giresun, Türkiye.
Objective:
Clostridioides difficile is one of the leading causes of antibiotic-associated diarrhea. Recurrent C. difficile infection (rCDI) is significant because of prolonged hospital stays, morbidity, and additional costs. Our study aimed to examine the characteristics of C. difficile infections and investigate factors associated with recurrence.
Materials And Methods:
Adult patients with signs of acute gastroenteritis and gastrointestinal polymerase chain reaction (GI PCR) panel tests performed on stool material, and C. difficile was detected as the causative agent were included in the study. rCDI was defined as the recurrence of symptoms and re-detection of C. difficile in the GI PCR panel within eight weeks after the onset of the initial episode in patients whose symptoms improved with appropriate antimicrobial treatment. Variables in patients with and without recurrence were compared, and risk factors for recurrence were investigated.
Results:
A total of 59 patients with C. difficile infection (CDI) were diagnosed. The median age of patients was 75, and 57.6% were male. Forty-nine patients (83.1%) were diagnosed with the infection while hospitalized. The most commonly used treatment was metronidazole. rCDI was identified in eight patients. The presence of malignancy, hematological malignancy, development of CDI episode in the intensive care unit, and continuation of antibiotic treatment for non-C. difficile etiology after CDI diagnosis were statistically more common in the recurrence group (p<0.05). Mortality during hospitalization occurred in a total of 11 patients (18.6%).
Conclusion:
CDI is important because of its frequent occurrence and potential for fatal outcomes. It is crucial to identify patients at risk for recurrence. In our study, the development of CDI attacks in the intensive care unit, malignancy, and continuation of antibiotic treatment for non-CDI infection after CDI diagnosis were found to be associated with recurrence. Evaluating these parameters in patient follow-up will contribute to prognostic assessment.
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