Increasing incidence of Clostridium difficile infections: results from a 5-year retrospective study in a large teaching hospital in the Italian region with the oldest population
Limited information is available on the incidence of Clostridium difficile infections (CDIs) in Italian hospitals. In this study, we assessed the changes in the incidence of CDI over a 5-year period in a teaching hospital in Liguria, the Italian region with the oldest population. Secondary endpoints...
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| Veröffentlicht in: | Epidemiology and infection 2016-09, Vol.144 (12), p.2517-2526 |
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| creator | ALICINO, C. GIACOBBE, D. R. DURANDO, P. BELLINA, D. DI BELLA, A. M. PAGANINO, C. DEL BONO, V. VISCOLI, C. ICARDI, G. ORSI, A. |
| description | Limited information is available on the incidence of Clostridium difficile infections (CDIs) in Italian hospitals. In this study, we assessed the changes in the incidence of CDI over a 5-year period in a teaching hospital in Liguria, the Italian region with the oldest population. Secondary endpoints were the development of severe CDI and 30-day mortality. The annual incidence of CDI/10000 patient-days significantly increased from 0·54 in 2010 to 3·04 in 2014 (χ2 for trend, P < 0·001). The median age of patients with CDI was 81 years. As many as 81% and 89% of these patients had comorbid conditions and previous exposure to antibiotics, respectively. In the multivariate analysis of risk factors for severe CDI, previous therapy with histamine 2 blockers and low serum albumin were associated with severe CDI, while diabetes appeared to be protective. In the multivariate model of risk factors for 30-day mortality, high leukocyte count, low serum albumin, and increased serum creatinine were unfavourably associated with outcome. Strict adherence to infection control measures was of utmost importance to counteract the increasing incidence of CDI in our hospital, particularly because of the advanced age of the patients and their very high frequency of chronic conditions and use of antibiotics, which readily predispose them to the development of CDI. |
| doi_str_mv | 10.1017/S0950268816000935 |
| format | Article |
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R. ; DURANDO, P. ; BELLINA, D. ; DI BELLA, A. M. ; PAGANINO, C. ; DEL BONO, V. ; VISCOLI, C. ; ICARDI, G. ; ORSI, A.</creator><creatorcontrib>ALICINO, C. ; GIACOBBE, D. R. ; DURANDO, P. ; BELLINA, D. ; DI BELLA, A. M. ; PAGANINO, C. ; DEL BONO, V. ; VISCOLI, C. ; ICARDI, G. ; ORSI, A.</creatorcontrib><description>Limited information is available on the incidence of Clostridium difficile infections (CDIs) in Italian hospitals. In this study, we assessed the changes in the incidence of CDI over a 5-year period in a teaching hospital in Liguria, the Italian region with the oldest population. Secondary endpoints were the development of severe CDI and 30-day mortality. The annual incidence of CDI/10000 patient-days significantly increased from 0·54 in 2010 to 3·04 in 2014 (χ2 for trend, P < 0·001). The median age of patients with CDI was 81 years. As many as 81% and 89% of these patients had comorbid conditions and previous exposure to antibiotics, respectively. In the multivariate analysis of risk factors for severe CDI, previous therapy with histamine 2 blockers and low serum albumin were associated with severe CDI, while diabetes appeared to be protective. In the multivariate model of risk factors for 30-day mortality, high leukocyte count, low serum albumin, and increased serum creatinine were unfavourably associated with outcome. Strict adherence to infection control measures was of utmost importance to counteract the increasing incidence of CDI in our hospital, particularly because of the advanced age of the patients and their very high frequency of chronic conditions and use of antibiotics, which readily predispose them to the development of CDI.</description><identifier>ISSN: 0950-2688</identifier><identifier>EISSN: 1469-4409</identifier><identifier>DOI: 10.1017/S0950268816000935</identifier><identifier>PMID: 27193828</identifier><language>eng</language><publisher>England: Cambridge University Press</publisher><subject>Age Factors ; Aged ; Aged, 80 and over ; Antibiotics ; Chronic obstructive pulmonary disease ; Clostridium difficile ; Clostridium difficile - physiology ; Clostridium Infections - epidemiology ; Clostridium Infections - microbiology ; Clostridium Infections - mortality ; Comorbidity ; Digital archives ; Enteropathogens ; Epidemiology ; Female ; Gastrointestinal diseases ; Heart attacks ; Heart failure ; Hemodialysis ; Hospitals, Teaching - statistics & numerical data ; Humans ; Incidence ; Infections ; Italy - epidemiology ; Length of stay ; Male ; Medical laboratories ; Mortality ; Multivariate Analysis ; Original Papers ; Patients ; Population ; Retrospective Studies ; Risk Factors ; Surgery ; Surveillance ; Teaching hospitals</subject><ispartof>Epidemiology and infection, 2016-09, Vol.144 (12), p.2517-2526</ispartof><rights>Cambridge University Press 2016</rights><rights>Copyright © Cambridge University Press 2016</rights><rights>Cambridge University Press 2016 2016 Cambridge University Press</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c530t-eb1148e0957d65148303f91270d6c8e638bc2c78658358853104cde84055d67b3</citedby><cites>FETCH-LOGICAL-c530t-eb1148e0957d65148303f91270d6c8e638bc2c78658358853104cde84055d67b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/26515766$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/26515766$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>230,314,723,776,780,799,881,27901,27902,53766,53768,57992,58225</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27193828$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>ALICINO, C.</creatorcontrib><creatorcontrib>GIACOBBE, D. R.</creatorcontrib><creatorcontrib>DURANDO, P.</creatorcontrib><creatorcontrib>BELLINA, D.</creatorcontrib><creatorcontrib>DI BELLA, A. M.</creatorcontrib><creatorcontrib>PAGANINO, C.</creatorcontrib><creatorcontrib>DEL BONO, V.</creatorcontrib><creatorcontrib>VISCOLI, C.</creatorcontrib><creatorcontrib>ICARDI, G.</creatorcontrib><creatorcontrib>ORSI, A.</creatorcontrib><title>Increasing incidence of Clostridium difficile infections: results from a 5-year retrospective study in a large teaching hospital in the Italian region with the oldest population</title><title>Epidemiology and infection</title><addtitle>Epidemiol Infect</addtitle><description>Limited information is available on the incidence of Clostridium difficile infections (CDIs) in Italian hospitals. In this study, we assessed the changes in the incidence of CDI over a 5-year period in a teaching hospital in Liguria, the Italian region with the oldest population. Secondary endpoints were the development of severe CDI and 30-day mortality. The annual incidence of CDI/10000 patient-days significantly increased from 0·54 in 2010 to 3·04 in 2014 (χ2 for trend, P < 0·001). The median age of patients with CDI was 81 years. As many as 81% and 89% of these patients had comorbid conditions and previous exposure to antibiotics, respectively. In the multivariate analysis of risk factors for severe CDI, previous therapy with histamine 2 blockers and low serum albumin were associated with severe CDI, while diabetes appeared to be protective. In the multivariate model of risk factors for 30-day mortality, high leukocyte count, low serum albumin, and increased serum creatinine were unfavourably associated with outcome. Strict adherence to infection control measures was of utmost importance to counteract the increasing incidence of CDI in our hospital, particularly because of the advanced age of the patients and their very high frequency of chronic conditions and use of antibiotics, which readily predispose them to the development of CDI.</description><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antibiotics</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Clostridium difficile</subject><subject>Clostridium difficile - physiology</subject><subject>Clostridium Infections - epidemiology</subject><subject>Clostridium Infections - microbiology</subject><subject>Clostridium Infections - mortality</subject><subject>Comorbidity</subject><subject>Digital archives</subject><subject>Enteropathogens</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Gastrointestinal diseases</subject><subject>Heart attacks</subject><subject>Heart failure</subject><subject>Hemodialysis</subject><subject>Hospitals, Teaching - statistics & numerical data</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infections</subject><subject>Italy - epidemiology</subject><subject>Length of stay</subject><subject>Male</subject><subject>Medical laboratories</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Original Papers</subject><subject>Patients</subject><subject>Population</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Surgery</subject><subject>Surveillance</subject><subject>Teaching hospitals</subject><issn>0950-2688</issn><issn>1469-4409</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkU1rFEEQhhtRks3HD_CgLHjJZWL1d_VFCIuaQMCD5tzM9vTEXma7Y_dMIP_enmyMJjl4qoL3qZeqegl5S-GUAtUfv4ORwBQiVQBguHxFFlQo0wgB5jVZzHIz6_vkoJTNzDDUe2SfaWo4MlwQvIgu-7aEeL0M0YXOR-eXqV-uhlTGHLowbZdd6PvgwuAr0ns3hhTLEXnTt0Pxxw_1kFx9-fxjdd5cfvt6sTq7bJzkMDZ-TalAXzfRnZK15cB7Q5mGTjn0iuPaMadRSeQSUXIKwnUeBUjZKb3mh-TTzvdmWm9953wcczvYmxy2bb6zqQ32qRLDT3udbq2hEoSm1eDkwSCnX5Mvo92G4vwwtNGnqVhqQAlpUKr_owgGhGL36Idn6CZNOdZPzBQyipKZStEd5XIqJfv-cW8Kdo7Qvoiwzrz_9-DHiT-ZVeDdDtiUMeW_en2v1Erx3_1tnf4</recordid><startdate>20160901</startdate><enddate>20160901</enddate><creator>ALICINO, C.</creator><creator>GIACOBBE, D. 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R.</au><au>DURANDO, P.</au><au>BELLINA, D.</au><au>DI BELLA, A. M.</au><au>PAGANINO, C.</au><au>DEL BONO, V.</au><au>VISCOLI, C.</au><au>ICARDI, G.</au><au>ORSI, A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Increasing incidence of Clostridium difficile infections: results from a 5-year retrospective study in a large teaching hospital in the Italian region with the oldest population</atitle><jtitle>Epidemiology and infection</jtitle><addtitle>Epidemiol Infect</addtitle><date>2016-09-01</date><risdate>2016</risdate><volume>144</volume><issue>12</issue><spage>2517</spage><epage>2526</epage><pages>2517-2526</pages><issn>0950-2688</issn><eissn>1469-4409</eissn><abstract>Limited information is available on the incidence of Clostridium difficile infections (CDIs) in Italian hospitals. In this study, we assessed the changes in the incidence of CDI over a 5-year period in a teaching hospital in Liguria, the Italian region with the oldest population. Secondary endpoints were the development of severe CDI and 30-day mortality. The annual incidence of CDI/10000 patient-days significantly increased from 0·54 in 2010 to 3·04 in 2014 (χ2 for trend, P < 0·001). The median age of patients with CDI was 81 years. As many as 81% and 89% of these patients had comorbid conditions and previous exposure to antibiotics, respectively. In the multivariate analysis of risk factors for severe CDI, previous therapy with histamine 2 blockers and low serum albumin were associated with severe CDI, while diabetes appeared to be protective. In the multivariate model of risk factors for 30-day mortality, high leukocyte count, low serum albumin, and increased serum creatinine were unfavourably associated with outcome. Strict adherence to infection control measures was of utmost importance to counteract the increasing incidence of CDI in our hospital, particularly because of the advanced age of the patients and their very high frequency of chronic conditions and use of antibiotics, which readily predispose them to the development of CDI.</abstract><cop>England</cop><pub>Cambridge University Press</pub><pmid>27193828</pmid><doi>10.1017/S0950268816000935</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Epidemiology and infection, 2016-09, Vol.144 (12), p.2517-2526 |
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| source | Jstor Complete Legacy; Open Access: PubMed Central; MEDLINE |
| subjects | Age Factors Aged Aged, 80 and over Antibiotics Chronic obstructive pulmonary disease Clostridium difficile Clostridium difficile - physiology Clostridium Infections - epidemiology Clostridium Infections - microbiology Clostridium Infections - mortality Comorbidity Digital archives Enteropathogens Epidemiology Female Gastrointestinal diseases Heart attacks Heart failure Hemodialysis Hospitals, Teaching - statistics & numerical data Humans Incidence Infections Italy - epidemiology Length of stay Male Medical laboratories Mortality Multivariate Analysis Original Papers Patients Population Retrospective Studies Risk Factors Surgery Surveillance Teaching hospitals |
| title | Increasing incidence of Clostridium difficile infections: results from a 5-year retrospective study in a large teaching hospital in the Italian region with the oldest population |
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