Journal of Clinical Medicine (Mar 2021)
Prospective Study on Incidence, Risk Factors and Outcome of Recurrent <em>Clostridioides difficile</em> Infections
- Guido Granata,
- Nicola Petrosillo,
- Lucia Adamoli,
- Michele Bartoletti,
- Alessandro Bartoloni,
- Gregorio Basile,
- Matteo Bassetti,
- Paolo Bonfanti,
- Raffaella Borromeo,
- Giancarlo Ceccarelli,
- Anna Maria De Luca,
- Stefano Di Bella,
- Sara Fossati,
- Erica Franceschini,
- Ivan Gentile,
- Daniele Roberto Giacobbe,
- Enrica Giacometti,
- Fabrizio Ingrassia,
- Filippo Lagi,
- Giambattista Lobreglio,
- Andrea Lombardi,
- Laura Isabella Lupo,
- Roberto Luzzati,
- Alberto Enrico Maraolo,
- Malgorzata Mikulska,
- Mario Umberto Mondelli,
- Alessandra Mularoni,
- Cristina Mussini,
- Alessandra Oliva,
- Alessandro Pandolfo,
- Carlotta Rogati,
- Filippo Fabio Trapani,
- Mario Venditti,
- Pierluigi Viale,
- Emanuela Caraffa,
- Maria Adriana Cataldo,
- on behalf of the ReCloDi (Recurrence of Clostridioides difficile Infection) Study Group
Affiliations
- Guido Granata
- Clinical and Research Department for Infectious Diseases, National Institute for Infectious Diseases L. Spallanzani IRCCS, 00149 Rome, Italy
- Nicola Petrosillo
- Clinical and Research Department for Infectious Diseases, National Institute for Infectious Diseases L. Spallanzani IRCCS, 00149 Rome, Italy
- Lucia Adamoli
- Infectious Diseases ISMETT IRCCS, 90127 Palermo, Italy
- Michele Bartoletti
- Department of Medical and Surgical Sciences, “Alma Mater Studiorum”, IRCCS S. Orsola Teaching Hospital, University of Bologna, 40126 Bologna, Italy
- Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy
- Gregorio Basile
- Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy
- Matteo Bassetti
- Department of Health Sciences (DISSAL), University of Genoa, 16126 Genoa, Italy
- Paolo Bonfanti
- Department of Infectious Diseases, San Gerardo Hospital, Monza—University of Milano-Bicocca, 20126 Milan, Italy
- Raffaella Borromeo
- Hospital of Crema, 26013 Crema, Italy
- Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Policlinico Umberto I, 00185 Rome, Italy
- Anna Maria De Luca
- Infectious Diseases ISMETT IRCCS, 90127 Palermo, Italy
- Stefano Di Bella
- Infectious Diseases Department, Azienda Sanitaria Universitaria Integrata di Trieste, 34128 Trieste, Italy
- Sara Fossati
- Infectious Diseases Department, Azienda Sanitaria Universitaria Integrata di Trieste, 34128 Trieste, Italy
- Erica Franceschini
- Clinic of Infectious Diseases, University of Modena and Reggio Emilia, 41121 Modena, Italy
- Ivan Gentile
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80138 Naples, Italy
- Daniele Roberto Giacobbe
- Department of Health Sciences (DISSAL), University of Genoa, 16126 Genoa, Italy
- Enrica Giacometti
- Infectious Diseases Clinic, Department of Medicine University of Udine and Azienda Sanitaria Universitaria Integrata di Udine, 33100 Udine, Italy
- Fabrizio Ingrassia
- Hospital of Crema, 26013 Crema, Italy
- Filippo Lagi
- Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy
- Giambattista Lobreglio
- Vito Fazzi Hospital, 73100 Lecce, Italy
- Andrea Lombardi
- Division of Infectious Diseases and Immunology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
- Laura Isabella Lupo
- Vito Fazzi Hospital, 73100 Lecce, Italy
- Roberto Luzzati
- Infectious Diseases Department, Azienda Sanitaria Universitaria Integrata di Trieste, 34128 Trieste, Italy
- Alberto Enrico Maraolo
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80138 Naples, Italy
- Malgorzata Mikulska
- Department of Health Sciences (DISSAL), University of Genoa, 16126 Genoa, Italy
- Mario Umberto Mondelli
- Division of Infectious Diseases and Immunology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
- Alessandra Mularoni
- Infectious Diseases ISMETT IRCCS, 90127 Palermo, Italy
- Cristina Mussini
- Clinic of Infectious Diseases, University of Modena and Reggio Emilia, 41121 Modena, Italy
- Alessandra Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Policlinico Umberto I, 00185 Rome, Italy
- Alessandro Pandolfo
- Infectious Diseases, ASST Lecco Hospital, 23900 Lecco, Italy
- Carlotta Rogati
- Clinic of Infectious Diseases, University of Modena and Reggio Emilia, 41121 Modena, Italy
- Filippo Fabio Trapani
- Department of Medical and Surgical Sciences, “Alma Mater Studiorum”, IRCCS S. Orsola Teaching Hospital, University of Bologna, 40126 Bologna, Italy
- Mario Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Policlinico Umberto I, 00185 Rome, Italy
- Pierluigi Viale
- Department of Medical and Surgical Sciences, “Alma Mater Studiorum”, IRCCS S. Orsola Teaching Hospital, University of Bologna, 40126 Bologna, Italy
- Emanuela Caraffa
- Clinical and Research Department for Infectious Diseases, National Institute for Infectious Diseases L. Spallanzani IRCCS, 00149 Rome, Italy
- Maria Adriana Cataldo
- Clinical and Research Department for Infectious Diseases, National Institute for Infectious Diseases L. Spallanzani IRCCS, 00149 Rome, Italy
- on behalf of the ReCloDi (Recurrence of Clostridioides difficile Infection) Study Group
- DOI
- https://doi.org/10.3390/jcm10051127
- Journal volume & issue
-
Vol. 10,
no. 5
p. 1127
Abstract
Background: Limited and wide-ranging data are available on the recurrent Clostridioides difficile infection (rCDI) incidence rate. Methods: We performed a cohort study with the aim to assess the incidence of and risk factors for rCDI. Adult patients with a first CDI, hospitalized in 15 Italian hospitals, were prospectively included and followed-up for 30 d after the end of antimicrobial treatment for their first CDI. A case–control study was performed to identify risk factors associated with 30-day onset rCDI. Results: Three hundred nine patients with a first CDI were included in the study; 32% of the CDI episodes (99/309) were severe/complicated; complete follow-up was available for 288 patients (19 died during the first CDI episode, and 2 were lost during follow-up). At the end of the study, the crude all-cause mortality rate was 10.7% (33 deaths/309 patients). Two hundred seventy-one patients completed the follow-up; rCDI occurred in 21% of patients (56/271) with an incidence rate of 72/10,000 patient-days. Logistic regression analysis identified exposure to cephalosporin as an independent risk factor associated with rCDI (RR: 1.7; 95% CI: 1.1–2.7, p = 0.03). Conclusion: Our study confirms the relevance of rCDI in terms of morbidity and mortality and provides a reliable estimation of its incidence.
Keywords