Abstract
Objectives: To describe clinical characteristics and outcome of Clostridium difficile infection (CDI) patients in Internal Medicine, to identify ribotypes (RTs); to evaluate the association between RT and patient clinical characteristics and report outcome. Methods: One year prospective cohort study. Clinical data, Barthel Index (BI) and outcomes were collected for all inpatients suffering from CDI (n = 148) in hospital wards in Northern Italy. 84 fecal samples were analysed for molecular typing. Results: 12 RTs were identified, predominantly RT018 (42.9%, n = 36/84) and RT356/607 (40.5%, n = 34/84). Patients with dementia were more frequent among those infected by RT018 [55.6% (n = 20/36) vs. 32.4% (n = 11/34), p = 0.05]. The median BI score of patients with RT018 was lower than BI score of patients with RT356/607 [10 (IQR 0–32) vs. 15 (IQR 5–50), p = 0.06]. RT018 infection was associated to higher levels of C-reactive protein [7.2 mg/dl (IQR 4.1–14.7) vs. 4.0 mg/dl (IQR 2.2–6.8), p = 0.01] and white blood cells ≥15,000/dl [33.3% (n = 12/36) vs. 14.7% (n = 5/34) of patients, p = 0.07]. Higher mortality was noted among RT018 infected patients. We found a continuous mortality increase according to the ATLAS score. Conclusions: Our results confirm that RT018 and RT356/607 are the two major RTs causing CDI in older patients with a high degree of disability in Northern Italy and RT018 is associated with more serious outcomes.
| Original language | English |
|---|---|
| Pages (from-to) | 21-26 |
| Journal | European Journal of Internal Medicine |
| Volume | 54 |
| DOIs | |
| Publication status | Published - 2018 |
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Keywords
- ATLAS score
- Barthel index
- Clinical outcomes
- Clostridium difficile infection
- PCR-ribotype 018
- PCR-ribotype 356/607
ASJC Scopus subject areas
- Internal Medicine
Cite this
Clinical outcomes of Clostridium difficile infection according to strain type. A prospective study in medical wards. / Serafino, S.; Consonni, D.; Migone De Amicis, M.; Sisto, F.; Domeniconi, G.; Formica, S.; Zarantonello, M.; Maraschini, A.; Cappellini, M. D.; Spigaglia, P.; Barbanti, F.; Castaldi, S.; Fabio, G.
In: European Journal of Internal Medicine, Vol. 54, 2018, p. 21-26.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Clinical outcomes of Clostridium difficile infection according to strain type. A prospective study in medical wards
AU - Serafino, S.
AU - Consonni, D.
AU - Migone De Amicis, M.
AU - Sisto, F.
AU - Domeniconi, G.
AU - Formica, S.
AU - Zarantonello, M.
AU - Maraschini, A.
AU - Cappellini, M. D.
AU - Spigaglia, P.
AU - Barbanti, F.
AU - Castaldi, S.
AU - Fabio, G.
PY - 2018
Y1 - 2018
N2 - Objectives: To describe clinical characteristics and outcome of Clostridium difficile infection (CDI) patients in Internal Medicine, to identify ribotypes (RTs); to evaluate the association between RT and patient clinical characteristics and report outcome. Methods: One year prospective cohort study. Clinical data, Barthel Index (BI) and outcomes were collected for all inpatients suffering from CDI (n = 148) in hospital wards in Northern Italy. 84 fecal samples were analysed for molecular typing. Results: 12 RTs were identified, predominantly RT018 (42.9%, n = 36/84) and RT356/607 (40.5%, n = 34/84). Patients with dementia were more frequent among those infected by RT018 [55.6% (n = 20/36) vs. 32.4% (n = 11/34), p = 0.05]. The median BI score of patients with RT018 was lower than BI score of patients with RT356/607 [10 (IQR 0–32) vs. 15 (IQR 5–50), p = 0.06]. RT018 infection was associated to higher levels of C-reactive protein [7.2 mg/dl (IQR 4.1–14.7) vs. 4.0 mg/dl (IQR 2.2–6.8), p = 0.01] and white blood cells ≥15,000/dl [33.3% (n = 12/36) vs. 14.7% (n = 5/34) of patients, p = 0.07]. Higher mortality was noted among RT018 infected patients. We found a continuous mortality increase according to the ATLAS score. Conclusions: Our results confirm that RT018 and RT356/607 are the two major RTs causing CDI in older patients with a high degree of disability in Northern Italy and RT018 is associated with more serious outcomes.
AB - Objectives: To describe clinical characteristics and outcome of Clostridium difficile infection (CDI) patients in Internal Medicine, to identify ribotypes (RTs); to evaluate the association between RT and patient clinical characteristics and report outcome. Methods: One year prospective cohort study. Clinical data, Barthel Index (BI) and outcomes were collected for all inpatients suffering from CDI (n = 148) in hospital wards in Northern Italy. 84 fecal samples were analysed for molecular typing. Results: 12 RTs were identified, predominantly RT018 (42.9%, n = 36/84) and RT356/607 (40.5%, n = 34/84). Patients with dementia were more frequent among those infected by RT018 [55.6% (n = 20/36) vs. 32.4% (n = 11/34), p = 0.05]. The median BI score of patients with RT018 was lower than BI score of patients with RT356/607 [10 (IQR 0–32) vs. 15 (IQR 5–50), p = 0.06]. RT018 infection was associated to higher levels of C-reactive protein [7.2 mg/dl (IQR 4.1–14.7) vs. 4.0 mg/dl (IQR 2.2–6.8), p = 0.01] and white blood cells ≥15,000/dl [33.3% (n = 12/36) vs. 14.7% (n = 5/34) of patients, p = 0.07]. Higher mortality was noted among RT018 infected patients. We found a continuous mortality increase according to the ATLAS score. Conclusions: Our results confirm that RT018 and RT356/607 are the two major RTs causing CDI in older patients with a high degree of disability in Northern Italy and RT018 is associated with more serious outcomes.
KW - ATLAS score
KW - Barthel index
KW - Clinical outcomes
KW - Clostridium difficile infection
KW - PCR-ribotype 018
KW - PCR-ribotype 356/607
UR - http://www.scopus.com/inward/record.url?scp=85045050629&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85045050629&partnerID=8YFLogxK
U2 - 10.1016/j.ejim.2018.03.015
DO - 10.1016/j.ejim.2018.03.015
M3 - Article
AN - SCOPUS:85045050629
VL - 54
SP - 21
EP - 26
JO - European Journal of Internal Medicine
JF - European Journal of Internal Medicine
SN - 0953-6205
ER -