Treatment and Outcomes of Clostridioides difficile Infection in Switzerland: A Two-Center Retrospective Cohort Study.

Détails

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Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_694295A9316A
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Treatment and Outcomes of Clostridioides difficile Infection in Switzerland: A Two-Center Retrospective Cohort Study.
Périodique
Journal of clinical medicine
Auteur⸱e⸱s
Filippidis P., Kampouri E., Woelfle M., Badinski T., Croxatto A., Galperine T., Papadimitriou-Olivgeris M., Grandbastien B., Achermann Y., Guery B.
ISSN
2077-0383 (Print)
ISSN-L
2077-0383
Statut éditorial
Publié
Date de publication
30/06/2022
Peer-reviewed
Oui
Volume
11
Numéro
13
Pages
3805
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
Objectives: Clostridioides difficile infection (CDI) is the leading cause of healthcare-associated diarrhea, often complicated by severe infection and recurrence with increased morbidity and mortality. Data from large cohorts in Switzerland are scarce. We aimed to describe diagnostic assays, treatment, outcomes, and risk factors for CDI in a large cohort of patients in Switzerland. Methods: We conducted a retrospective cohort study of CDI episodes diagnosed in patients from two tertiary care hospitals in Switzerland. During a 3-month follow-up, we used a composite outcome combining clinical cure at day 10, recurrence at week 8, or death, to evaluate a patient’s response. Unfavorable outcomes consisted in the occurrence of any of these events. Results: From January 2014 to December 2018, we included 826 hospitalized patients with documented CDI. Overall, 299 patients (36.2%) had a severe infection. Metronidazole was used in 566 patients (83.7%), compared to 82 patients (12.1%) treated with vancomycin and 28 patients (4.1%) treated with fidaxomicin. Overall mortality at week 8 was at 15.3% (112/733). Eighty-six patients (12.7%) presented with clinical failure at day 10, and 78 (14.9%) presented with recurrence within 8 weeks; 269 (39.8%) met the composite outcome of death, clinical failure, or recurrence. The Charlson Comorbidity Index score (p < 0.001), leukocytes > 15 G/L (p = 0.008), and the use of metronidazole (p = 0.012) or vancomycin (p = 0.049) were factors associated with the composite outcome. Conclusions: Our study provides valuable insights on CDI treatment and outcomes in Switzerland, highlights the heterogeneity in practices among centers, and underlines the need for the active monitoring of clinical practices and their impact on clinical outcomes through large multicentric cohorts.
Mots-clé
Clostridioides difficile, mortality, outcomes, predictive factors, recurrence, severe infection, treatment
Pubmed
Web of science
Open Access
Oui
Création de la notice
18/07/2022 10:59
Dernière modification de la notice
06/07/2023 7:00
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