1887

Abstract

Background

infection (CDI) adversely affects patient outcomes. CDI 30-day mortality is 15.2% nationally with some regional variation, but data on recurrence is limited. We assessed outcomes of CDI, in particular recurrence and mortality at Addenbrooke’s Hospital.

Methods

We performed a retrospective analysis of all patients who developed CDI between April 2017 and March 2018. All-cause mortality was assessed at 30 days and 1 year. Recurrence was defined as recurrence of symptoms withC. difficiletoxin positive stool or initiationof treatment within 1-year after onset of first/previous episode. First-line therapy was metronidazole or vancomycin according to severity.

Clinical data was collected using a standardised proforma. Risk of recurrence was calculated using Cox’s Hazard method in R.

Results

143 cases of CDI in 103 patients were identified. The median age was 70 years (range 2-98). Recurrence rate was 24.6% at 12-weeks and 30.3% at 1-year. 30-day and 1-year mortality was 14.4% and 39.8%, respectively. Recurrences had longer mean length of stay compared to 1stepisodes (40.3 vs. 18 days, respectively, p<0.05). On univariate analysis, no factors predicted recurrence; acute kidney injury, C-reactive protein, toxic megacolon, Charlson comorbidity score and age predicted mortality.

Conclusions

CDI carries a significant mortality and recurrence rate placing a large burden on hospital resources. The majority of recurrences occur within 12 weeks of 1stepisode, and patients’ risk could not be accurately defined in this sample. Newer therapies with reported lower recurrence rates should be considered as 1stline therapy within our Trust.

Loading

Article metrics loading...

/content/journal/acmi/10.1099/acmi.fis2019.po0105
2020-02-28
2020-06-04
Loading full text...

Full text loading...

http://instance.metastore.ingenta.com/content/journal/acmi/10.1099/acmi.fis2019.po0105
Loading

Most cited this month Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error