Abstract
BackgroundThe objective of this study was to investigate independent risk factors (RFs) connected with healthcare-associated (HA) Clostridium difficile infection (CDI) in surgical patients, its frequency per surgical wards and in-hospital-mortality at a single hospital.MethodsRisk factors for the infection were prospectively assessed among surgical patients with laboratory confirmed HA CDI and compared with a control group without HA CDI.ResultsThe overall incidence rate of HA CDI was 2.6 per 10000 patient-days. Significant independent RFs for HA CDI were the use of carbapenems (P = 0.007, OR: 10.62, 95% CI: 1.93–58.4), the admission to intensive care unit (P = 0.004, OR:3.00, 95% CI:1.41–6.40), and the administration of 3rd generation cephalosporins (P = 0.014, OR:2.27, 95% CI:1.18–4.39). Patients with HA CDI had significantly higher in–hospital mortality compared to controls (P: 0.007; OR: 8.95; 95% CI: 1.84–43.43).ConclusionsCDI is an important HA infection in population of surgical patients and this study emphasizes the importance of the wise use of antibiotics, and other infection control strategies in order to prevent HA CDI, and to decrease the incidence and in-hospital mortality rate.
Highlights
The objective of this study was to investigate independent risk factors (RFs) connected with healthcare-associated (HA) Clostridium difficile infection (CDI) in surgical patients, its frequency per surgical wards and in-hospital-mortality at a single hospital
Multivariate logistic regression analysis (MLRA) identified three independent RFs associated with CDI in surgical patients: the previous administration of carbapenems (P = 0.007, OR:10.62, 95% confidence intervals (CI):1.93–58.4), the 3rd generation of cephalosporins (P = 0.014, OR:2.27, 95% CI:1.18–4.39) and admission to the intensive care unit (ICU) (P = 0.004, OR:3.00, 95% CI:1.41–6.40)
According to the ULRA, pump inhibitors (PPIs) usage was a significant RF for HA CDI (P = 0.05), but it was not a significant independent RF according to MLRA (P = 0.051, OR:2.7, 95% CI:1.00–7.19)
Summary
The objective of this study was to investigate independent risk factors (RFs) connected with healthcare-associated (HA) Clostridium difficile infection (CDI) in surgical patients, its frequency per surgical wards and in-hospital-mortality at a single hospital. The increase of CDI incidence was partly associated with the epidemic emergence of a new C. difficile ribotype 027, which was described to cause more severe infections [1]. CDI became one of the most common healthcare-associated (HA) infections in modern. The burden of CDI in Serbia, a country in socioeconomic transition and with a resourcelimited healthcare system, is less well studied [3, 11]. The aim of this study was to investigate independent RFs associated with HA CDI in surgical patients, its frequency per surgical wards and in-hospital-mortality in a tertiary healthcare centre in Serbia
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