Clostridioides difficile infection after cardiac surgery: Assessment of prevalence, risk factors and clinical outcomes—retrospective study
Background Clostridioides difficile infection (CDI) is the most common cause of hospital-acquired diarrhea. There is little available data regarding risk factors of CDI for patients who undergo cardiac surgery. The study evaluated the course of CDI in patients after cardiac surgery. Methods Of 6,198...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
PeerJ Inc.
2020-09-01
|
| Series: | PeerJ |
| Subjects: | |
| Online Access: | https://peerj.com/articles/9972.pdf |
| _version_ | 1797419979882102784 |
|---|---|
| author | Anna Rzucidło-Hymczak Hubert Hymczak Aldona Olechowska-Jarząb Anna Gorczyca Boguslaw Kapelak Rafał Drwiła Dariusz Plicner |
| author_facet | Anna Rzucidło-Hymczak Hubert Hymczak Aldona Olechowska-Jarząb Anna Gorczyca Boguslaw Kapelak Rafał Drwiła Dariusz Plicner |
| author_sort | Anna Rzucidło-Hymczak |
| collection | DOAJ |
| description | Background Clostridioides difficile infection (CDI) is the most common cause of hospital-acquired diarrhea. There is little available data regarding risk factors of CDI for patients who undergo cardiac surgery. The study evaluated the course of CDI in patients after cardiac surgery. Methods Of 6,198 patients studied, 70 (1.1%) developed CDI. The control group consisted of 73 patients in whom CDI was excluded. Perioperative data and clinical outcomes were analyzed. Results Patients with CDI were significantly older in comparison to the control group (median age 73.0 vs 67.0, P = 0.005) and more frequently received proton pump inhibitors, statins, β-blockers and acetylsalicylic acid before surgery (P = 0.008, P = 0.012, P = 0.004, and P = 0.001, respectively). In addition, the presence of atherosclerosis, coronary disease and history of malignant neoplasms correlated positively with the development of CDI (P = 0.012, P = 0.036 and P = 0.05, respectively). There were no differences in the type or timing of surgery, aortic cross-clamp and cardiopulmonary bypass time, volume of postoperative drainage and administration of blood products between the studied groups. Relapse was more common among overweight patients with high postoperative plasma glucose or patients with higher C-reactive protein during the first episode of CDI, as well as those with a history of coronary disease or diabetes mellitus (P = 0.005, P = 0.030, P = 0.009, P = 0.049, and P = 0.025, respectively). Fifteen patients died (21.4%) from the CDI group and 7 (9.6%) from the control group (P = 0.050). Emergent procedures, prolonged stay in the intensive care unit, longer mechanical ventilation and high white blood cell count during the diarrhea were associated with higher mortality among patients with CDI (P = 0.05, P = 0.041, P = 0.004 and P = 0.007, respectively). Conclusions The study did not reveal any specific cardiac surgery-related risk factors for development of CDI. |
| first_indexed | 2024-03-09T06:55:00Z |
| format | Article |
| id | doaj.art-476f0fc3978940bfb2da6245d761637c |
| institution | Directory Open Access Journal |
| issn | 2167-8359 |
| language | English |
| last_indexed | 2024-03-09T06:55:00Z |
| publishDate | 2020-09-01 |
| publisher | PeerJ Inc. |
| record_format | Article |
| series | PeerJ |
| spelling | doaj.art-476f0fc3978940bfb2da6245d761637c2023-12-03T10:04:21ZengPeerJ Inc.PeerJ2167-83592020-09-018e997210.7717/peerj.9972Clostridioides difficile infection after cardiac surgery: Assessment of prevalence, risk factors and clinical outcomes—retrospective studyAnna Rzucidło-Hymczak0Hubert Hymczak1Aldona Olechowska-Jarząb2Anna Gorczyca3Boguslaw Kapelak4Rafał Drwiła5Dariusz Plicner6Department of Infectious Diseases, John Paul II Hospital, Krakow, PolandDepartment of Anesthesiology, John Paul II Hospital, Krakow, PolandDepartment of Microbiology, John Paul II Hospital, Krakow, PolandDepartment of Infectious Diseases, John Paul II Hospital, Krakow, PolandDepartment of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Krakow, PolandMedical College, Jagiellonian University, Krakow, PolandUnit of Experimental Cardiology and Cardiac Surgery, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, PolandBackground Clostridioides difficile infection (CDI) is the most common cause of hospital-acquired diarrhea. There is little available data regarding risk factors of CDI for patients who undergo cardiac surgery. The study evaluated the course of CDI in patients after cardiac surgery. Methods Of 6,198 patients studied, 70 (1.1%) developed CDI. The control group consisted of 73 patients in whom CDI was excluded. Perioperative data and clinical outcomes were analyzed. Results Patients with CDI were significantly older in comparison to the control group (median age 73.0 vs 67.0, P = 0.005) and more frequently received proton pump inhibitors, statins, β-blockers and acetylsalicylic acid before surgery (P = 0.008, P = 0.012, P = 0.004, and P = 0.001, respectively). In addition, the presence of atherosclerosis, coronary disease and history of malignant neoplasms correlated positively with the development of CDI (P = 0.012, P = 0.036 and P = 0.05, respectively). There were no differences in the type or timing of surgery, aortic cross-clamp and cardiopulmonary bypass time, volume of postoperative drainage and administration of blood products between the studied groups. Relapse was more common among overweight patients with high postoperative plasma glucose or patients with higher C-reactive protein during the first episode of CDI, as well as those with a history of coronary disease or diabetes mellitus (P = 0.005, P = 0.030, P = 0.009, P = 0.049, and P = 0.025, respectively). Fifteen patients died (21.4%) from the CDI group and 7 (9.6%) from the control group (P = 0.050). Emergent procedures, prolonged stay in the intensive care unit, longer mechanical ventilation and high white blood cell count during the diarrhea were associated with higher mortality among patients with CDI (P = 0.05, P = 0.041, P = 0.004 and P = 0.007, respectively). Conclusions The study did not reveal any specific cardiac surgery-related risk factors for development of CDI.https://peerj.com/articles/9972.pdfClostridioides difficile infectionCardiac surgeryRisk factors |
| spellingShingle | Anna Rzucidło-Hymczak Hubert Hymczak Aldona Olechowska-Jarząb Anna Gorczyca Boguslaw Kapelak Rafał Drwiła Dariusz Plicner Clostridioides difficile infection after cardiac surgery: Assessment of prevalence, risk factors and clinical outcomes—retrospective study PeerJ Clostridioides difficile infection Cardiac surgery Risk factors |
| title | Clostridioides difficile infection after cardiac surgery: Assessment of prevalence, risk factors and clinical outcomes—retrospective study |
| title_full | Clostridioides difficile infection after cardiac surgery: Assessment of prevalence, risk factors and clinical outcomes—retrospective study |
| title_fullStr | Clostridioides difficile infection after cardiac surgery: Assessment of prevalence, risk factors and clinical outcomes—retrospective study |
| title_full_unstemmed | Clostridioides difficile infection after cardiac surgery: Assessment of prevalence, risk factors and clinical outcomes—retrospective study |
| title_short | Clostridioides difficile infection after cardiac surgery: Assessment of prevalence, risk factors and clinical outcomes—retrospective study |
| title_sort | clostridioides difficile infection after cardiac surgery assessment of prevalence risk factors and clinical outcomes retrospective study |
| topic | Clostridioides difficile infection Cardiac surgery Risk factors |
| url | https://peerj.com/articles/9972.pdf |
| work_keys_str_mv | AT annarzucidłohymczak clostridioidesdifficileinfectionaftercardiacsurgeryassessmentofprevalenceriskfactorsandclinicaloutcomesretrospectivestudy AT huberthymczak clostridioidesdifficileinfectionaftercardiacsurgeryassessmentofprevalenceriskfactorsandclinicaloutcomesretrospectivestudy AT aldonaolechowskajarzab clostridioidesdifficileinfectionaftercardiacsurgeryassessmentofprevalenceriskfactorsandclinicaloutcomesretrospectivestudy AT annagorczyca clostridioidesdifficileinfectionaftercardiacsurgeryassessmentofprevalenceriskfactorsandclinicaloutcomesretrospectivestudy AT boguslawkapelak clostridioidesdifficileinfectionaftercardiacsurgeryassessmentofprevalenceriskfactorsandclinicaloutcomesretrospectivestudy AT rafałdrwiła clostridioidesdifficileinfectionaftercardiacsurgeryassessmentofprevalenceriskfactorsandclinicaloutcomesretrospectivestudy AT dariuszplicner clostridioidesdifficileinfectionaftercardiacsurgeryassessmentofprevalenceriskfactorsandclinicaloutcomesretrospectivestudy |