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Related Experiment Videos

Clostridium difficile colitis associated with chronic renal failure

R J Cunney1, C Magee, E McNamara

  • 1Department of Clinical Microbiology, Beaumont Hospital, Dublin, Ireland.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|November 26, 1998
PubMed
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Clostridium difficile-associated diarrhoea (CDAD) is a serious threat in nephrology patients, particularly those with chronic renal failure (CRF), leading to high mortality. Early diagnosis and rational antibiotic use are crucial for managing this condition.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Microbiology

Background:

  • Clostridium difficile-associated diarrhoea (CDAD) presents a significant health risk, disproportionately affecting patients with chronic renal failure (CRF).
  • A focused review was conducted within a nephrology unit to investigate CDAD prevalence and characteristics.

Purpose of the Study:

  • To determine the incidence and impact of CDAD in a nephrology patient population.
  • To identify risk factors, clinical presentations, and outcomes associated with CDAD in CRF patients.

Main Methods:

  • A retrospective review of 32 CDAD cases over 24 months using microbiology and histology records.
  • Analysis of patient notes for risk factors, clinical features, and outcomes.
  • 16S ribosomal RNA typing was performed on available C. difficile isolates.

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Main Results:

  • Nephrology unit CDAD incidence was 10.7/1000 admissions, significantly higher than other hospital areas (2.7/1000).
  • CDAD was a principal cause of death in 19% and a contributing factor in 22%; mortality was higher in CRF patients (P=0.04).
  • Inappropriate antibiotic therapy was noted in 15 of 26 patients with recent antibiotic use.

Conclusions:

  • CDAD poses a high mortality risk for nephrology patients, especially those with CRF.
  • Missed diagnoses can occur without thorough antibiotic history, including pre-admission agents.
  • Rational antibiotic prescribing and infection control are essential to mitigate CDAD incidence.