Determining the risk factors associated with the development of Clostridium difficile infection in patients with hematological diseases
- Author:
Yu Ling LEE-TSAI
1
;
Rodrigo LUNA-SANTIAGO
;
Roberta DEMICHELIS-GÓMEZ
;
Alfredo PONCE-DE-LEÓN
;
Eric OCHOA-HEIN
;
Karla María TAMEZ-TORRES
;
María T BOURLON
;
Christianne BOURLON
Author Information
- Publication Type:Original Article
- Keywords: Clostridium difficile; Hematologic diseases; Risk factors; Tertiary care centers
- MeSH: Anti-Bacterial Agents; Case-Control Studies; Clostridium difficile; Clostridium; Hematologic Diseases; Hematologic Neoplasms; Hospitalization; Humans; Intensive Care Units; Mortality; Multivariate Analysis; Retrospective Studies; Risk Factors; Tertiary Care Centers
- From:Blood Research 2019;54(2):120-124
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: Clostridium difficile infection (CDI) is a nosocomial condition prevalent in patients with hematological disorders. We aimed to identify the risk factors associated with the development of CDI and assess the mortality rate at 15 and 30 days among hematologic patients admitted to a tertiary care center. METHODS: We conducted a retrospective case-control study from January 2010 to December 2015. Forty-two patients with hematologic malignancy and CDI, and 84 with hematologic disease and without history of CDI were included in the case and control groups, respectively. RESULTS: Univariate analysis revealed that episodes of febrile eutropenia [odds ratio (OR), 5.5; 95% confidence interval (CI), 2.3–12.9; P<0.001], admission to intensive care unit (OR, 3.8; 95% CI, 1.4–10.2; P=0.009), gastrointestinal surgery (OR, 1.2; 95% CI, 1.1–1.4; P<0.001), use of therapeutic (OR, 6.4; 95% CI, 2.5–15.9; P<0.001) and prophylactic antibiotics (OR, 4.2; 95% CI, 1.6–10.7; P=0.003) in the last 3 months, and >1 hospitalization (OR, 5.6; 95% CI, 2.5–12.6; P<0.001) were significant risk factors. Multivariate analysis showed that use of therapeutic antibiotics in the last 3 months (OR, 6.3; 95% CI, 2.1–18.8; P=0.001) and >1 hospitalization (OR, 4.3; 95% CI, 1.7–11.0; P=0.002) were independent risk factors. Three (7.1%) and 6 (14.2%) case patients died at 15 and 30 days, respectively. CONCLUSION: The risk factors for developing CDI were exposure to therapeutic antibiotics and previous hospitalization. Hematological patients who developed CDI had higher early mortality rates, suggesting that new approaches for prevention and treatment are needed.
