Abstract
Clostridium difficile infection (CDI) is the most common infectious disease related to antibiotic-associated diarrhoea and is a current leading cause of morbidity/mortality, with substantial consequences for healthcare services and overall public health. Thus, we performed a retrospective epidemiological study of CDI for a long period (8 years), in an infectious hospital located in north-western Romania, which serves an entire county of the country (617,827 inhabitants). From 2011 to 2018, 877 patients were diagnosed with CDI; the mean incidence of this disease was 2.76 cases/10,000 patient-days, with an increasing trend in the annual incidence until 2016, at which point there was a decrease. The most commonly afflicted were patients in the 75–84 age group, observed in winter and spring. The results show that the antibiotics were administered in 679 (77.42%) subjects, within the last 3 months before CDI, statistically significant more than proton-pump inhibitors (PPIs)—128 (14.60%) and antidepressant medications—60 (6.84%), which were administered during the same period (p < 0.001). No medication was reported in 10 (6.84%) cases of CDI, in the last 3 months of the study. The fatality rate attained 4.1%, tripling in 2018 vs. 2011. CDI became a significant public health conundrum that can, nevertheless, be combatted through a judicious use of antibiotics.
Highlights
Clostridium difficile (CD) is omnipresent in the environment; it is considered to be a greatly important bacterium in diarrhoea-associated disease, for both different animal species and human
As the most encountered cause of infections connected to the healthcare field, CD is a major concern for the medical network [5,6]
Regarding the increased incidence of CD infection (CDI), even among the population considered to be at low risk to become infected and to monitor the incidence and to establish the population at risk, this study aimed to present long-term epidemiologic data correlated with the evolution of CDI incidence, and the way in which the marked increase in antibiotic consumption influences it
Summary
Clostridium difficile (CD) is omnipresent in the environment; it is considered to be a greatly important bacterium in diarrhoea-associated disease, for both different animal species and human. The incidence and the severity of CD infection (CDI) have significantly increased worldwide during the last two decades [1] Often fatal, it can aggravate already existing pathologies and is responsible for generating outbreaks of nosocomial infections [2,3]. In order to obtain better care and prevention on a large scale, programs and efficient interventions, with scalable and sustainable impact, need to be implemented in healthcare systems. All public health actions have to consider sustainability as well as the development of strategies for CDI from the individual disease management to a more consistent global medical approach [8]. In order to restrain the rates of CDI and decrease morbidity, it is necessary to approach CD as a global health issue and to raise consciousness of its impact [9]
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