Late poor outcomes of Clostridioides difficile infections in oncological patients: A multicentre cohort study.

IF 0.9 Q4 INFECTIOUS DISEASES

Journal of Infection Prevention Pub Date : 2023-07-01 Epub Date: 2023-03-21 DOI:10.1177/17571774231165410

Esther Calbo, Sergi Hernández, Nieves Sopena, Laia Castellá, Joaquín Lopez-Contreras, Jordi Cuquet, Maria López-Sánchez, Rafel Pérez, Carlota Gudiol, Ana Coloma, Mariló Marimón, Joan Espinach, Marta Andres, Purificación Martos, Gonçalo Carvalho Rodrigues, Enric Limón

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引用次数: 0

Abstract

Background: Cancer has been associated with an increased risk of in-hospital mortality in CDI patients. However, data on delayed mortality in cancer patients with CDI are scarce.

Aim/objective: The aim of the present study was to compare outcomes between oncological patients and the general population with Clostridioides difficile infection (CDI) after 90 days of follow-up.

Methods: A multicenter prospective cohort study was conducted in 28 hospitals participating in the VINCat program. Cases were all consecutive adult patients who met the case definition of CDI. Sociodemographic, clinical, and epidemiological variables and evolution at discharge and after 90 days were recorded for each case.

Findings/results: The mortality rate was higher in oncological patients (OR = 1.70, 95% CI: 1.08-2.67). In addition, oncological patients receiving chemotherapy (CT) presented higher recurrence rates (18.5% vs 9.8%, p = 0.049). Among oncological patients treated with metronidazole, those with active CT showed a higher rate of recurrence (35.3% vs 8.0% p = 0.04).

Discussion: Oncological patients presented a higher risk of poor outcomes after CDI. Their early and late mortality rates were higher than in the general population, and in parallel, those undergoing chemotherapy (especially those receiving metronidazole) had higher rates of recurrence.

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肿瘤患者艰难梭菌感染的晚期不良后果：一项多中心队列研究。

背景：癌症与 CDI 患者院内死亡风险增加有关。然而，有关癌症病人感染艰难梭菌后的延迟死亡率的数据却很少：本研究的目的是比较肿瘤患者和普通难辨梭状芽孢杆菌感染（CDI）患者在 90 天随访后的结果：在参与 VINCat 计划的 28 家医院开展了一项多中心前瞻性队列研究。病例均为符合 CDI 病例定义的连续成年患者。研究记录了每个病例的社会人口学、临床和流行病学变量以及出院时和出院 90 天后的演变情况：肿瘤患者的死亡率较高（OR = 1.70，95% CI：1.08-2.67）。此外，接受化疗（CT）的肿瘤患者复发率更高（18.5% vs 9.8%，P = 0.049）。在接受甲硝唑治疗的肿瘤患者中，CT活跃的患者复发率更高（35.3% vs 8.0% p = 0.04）：讨论：肿瘤患者在感染 CDI 后出现不良预后的风险较高。讨论：肿瘤患者在感染 CDI 后出现不良预后的风险较高，其早期和晚期死亡率均高于普通人群，同时，接受化疗者（尤其是接受甲硝唑治疗者）的复发率较高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection Prevention Nursing-Advanced and Specialized Nursing

CiteScore

1.70

自引率

8.30%

发文量

期刊介绍： Journal of Infection Prevention is the professional publication of the Infection Prevention Society. The aim of the journal is to advance the evidence base in infection prevention and control, and to provide a publishing platform for all health professionals interested in this field of practice. Journal of Infection Prevention is a bi-monthly peer-reviewed publication containing a wide range of articles: ·Original primary research studies ·Qualitative and quantitative studies ·Reviews of the evidence on various topics ·Practice development project reports ·Guidelines for practice ·Case studies ·Overviews of infectious diseases and their causative organisms ·Audit and surveillance studies/projects