Clostridium difficile infections are becoming a more serious problem as hospital-acquired infections and the consequence of common antibiotic therapy, also on an out-patient basis.
Aim of the study: The aim of the study was the epidemiological and clinical analysis of patients with Clostridium difficile-associated disease (CDAD) at the Clinical Department of Infectious Diseases and Hepatology, Bytom in 2014.
Material and methods: A retrospective analysis of the medical documentation of patients with the diagnosis of CDAD was performed. The study group was comprised of 24 patients. The following factors were analysed: gender, age, recent hospitalization, use of proton-pump inhibitors, H2-receptor inhibitors, use of antibiotics, co-morbidities, and the clinical course with consideration given to additional laboratory tests (CRP, creatinine, WBC count).
Results: All patients with diagnosed CDAD had been previously hospitalized and 75% of subjects were treated with antibiotics in the period preceding the onset of the disease. Recurrence of the disease was observed in 29% of cases, on average, 12.5 days after hospital discharge. In 16.7% of patients, CDAD resulted in death. Higher CRP concentrations on admission were observed in patients who died compared to the survivors (91.1 mg/l vs. 33.6 mg/l, p=0.015). Additionally, higher concentrations of CRP and leukocytosis were observed in patients with an unfavourable outcome of the disease. Respiratory insufficiency and hypotension were connected with a higher risk of death.
Conclusion: Hospitalization, antibiotic therapy, advanced age and co-morbidities may contribute to the occurrence of CDAD. In our study, initially high concentrations of CRP, respiratory insufficiency and hypotension were the predictive factors of a fatal outcome of the disease. The dynamics of changes in the leukocyte value and CRP concentration were of lesser importance.