Treatment outcomes and risk factors for severity and mortality in Clostridioides difficile infection: a single-center study in Thailand.

IF 1.2 4区医学 Q4 INFECTIOUS DISEASES

Journal of Infection in Developing Countries Pub Date : 2025-08-31 DOI:10.3855/jidc.20742

Thamonwan Chaemprida, Worapong Nasomsong

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引用次数: 0

Abstract

Introduction: Clostridioides difficile often causes hospital-acquired diarrhea, leading to unfavorable treatment outcomes. This study investigates CDI treatment outcomes and factors affecting severity and mortality at a university hospital in Thailand.

Methodology: A retrospective study was conducted from June 2019 to December 2021. The primary endpoints were treatment outcomes with a 95% CI. Univariable and multivariable Cox regression analyses determined risk factors for severe CDI and 30-day mortality.

Results: Of 187 patients receiving a diagnosis of and receiving treatment for CDI, 103 patients (55.8%) presented non-severe CDI, and 84 patients (44.2%) had severe CDI. The 30-day mortality rate of CDI was 24.1%, which was significantly higher in the severe group (36.9 vs. 13.6%, p ≤ 0.001). Multivariable analysis revealed the independent risk factor for severe CDI was chronic kidney disease (aOR 15.16, 95% CI 6.3, 36.48), and risk factors for all-cause mortality at 30 days were ICU admission (aOR 3.56, 95%CI 1.48, 8.56) and carbapenem exposure (aOR 2.79, 95% CI 1.17, 6.68).

Conclusions: This study demonstrated high mortality rates and a significant incidence of refractory and recurrent infections in the severe CDI group. Chronic kidney disease was an independent risk factor for severe CDI. ICU admission and carbapenem exposure were independent risk factors for all-cause mortality.

查看原文本刊更多论文

艰难梭菌感染的治疗结果和严重程度和死亡率的危险因素：泰国的一项单中心研究

艰难梭菌常引起医院获得性腹泻，导致不良的治疗结果。本研究调查了泰国一所大学医院的CDI治疗结果和影响严重程度和死亡率的因素。方法：回顾性研究于2019年6月至2021年12月进行。主要终点为治疗结果，CI为95%。单变量和多变量Cox回归分析确定了严重CDI和30天死亡率的危险因素。结果：187例确诊并接受治疗的CDI患者中，非重度CDI 103例（55.8%），重度CDI 84例（44.2%）。CDI患者30天死亡率为24.1%，重症组明显高于重症组（36.9% vs. 13.6%, p≤0.001）。多变量分析显示，严重CDI的独立危险因素是慢性肾脏疾病（aOR 15.16, 95%CI 6.3, 36.48）， 30天全因死亡率的危险因素是ICU入院（aOR 3.56, 95%CI 1.48, 8.56）和碳青霉烯类暴露（aOR 2.79, 95%CI 1.17, 6.68）。结论：本研究表明重症CDI组死亡率高，难治性和复发性感染发生率高。慢性肾脏疾病是严重CDI的独立危险因素。ICU住院和碳青霉烯暴露是全因死亡率的独立危险因素。

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 in Developing Countries INFECTIOUS DISEASES-

CiteScore

3.70

自引率

5.30%

发文量

239

审稿时长

4-8 weeks

期刊介绍： The Journal of Infection in Developing Countries (JIDC) is an international journal, intended for the publication of scientific articles from Developing Countries by scientists from Developing Countries. JIDC is an independent, on-line publication with an international editorial board. JIDC is open access with no cost to view or download articles and reasonable cost for publication of research artcles, making JIDC easily availiable to scientists from resource restricted regions.