<i>Clostridioides difficile</i> Infection among Cirrhotic Patients with Variceal Bleeding
<i>Clostridioides difficile</i> infection (CDI) stands as the leading cause of nosocomial infection with high morbidity and mortality rates, causing a major burden on the healthcare system. Driven by antibiotics, it usually affects older patients with chronic disease or immunosuppressed...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-06-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/10/6/731 |
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| author | Mirela Nicoleta Voicu Florica Popescu Dan Nicolae Florescu Ion Rogoveanu Adina Turcu-Stiolica Dan Ionut Gheonea Vlad Florin Iovanescu Sevastita Iordache Sergiu Marian Cazacu Bogdan Silviu Ungureanu |
| author_facet | Mirela Nicoleta Voicu Florica Popescu Dan Nicolae Florescu Ion Rogoveanu Adina Turcu-Stiolica Dan Ionut Gheonea Vlad Florin Iovanescu Sevastita Iordache Sergiu Marian Cazacu Bogdan Silviu Ungureanu |
| author_sort | Mirela Nicoleta Voicu |
| collection | DOAJ |
| description | <i>Clostridioides difficile</i> infection (CDI) stands as the leading cause of nosocomial infection with high morbidity and mortality rates, causing a major burden on the healthcare system. Driven by antibiotics, it usually affects older patients with chronic disease or immunosuppressed or oncologic management. Variceal bleeding secondary to cirrhosis requires antibiotics to prevent bacterial translocation, and thus patients become susceptible to CDI. We aimed to investigate the risk factors for CDI in cirrhotic patients with variceal bleeding following ceftriaxone and the mortality risk in this patient’s population. We retrospectively screened 367 cirrhotic patients with variceal bleeding, from which 25 patients were confirmed with CDI, from 1 January 2017 to 31 December 2019. We found MELD to be the only multivariate predictor for mortality (odds ratio, OR = 1.281, 95% confidence interval, CI: 0.098–1.643, <i>p</i> = 0.042). A model of four predictors (age, days of admission, Charlson index, Child–Pugh score) was generated (area under the receiver operating characteristics curve, AUC = 0.840, 95% CI: 0.758–0.921, <i>p</i> < 0.0001) to assess the risk of CDI exposure. Determining the probability of getting CDI for cirrhotic patients with variceal bleeding could be a tool for doctors in taking decisions, which could be integrated in sustainable public health programs. |
| first_indexed | 2024-03-10T10:20:35Z |
| format | Article |
| id | doaj.art-883a50cf561d48859533856209eeeaf7 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T10:20:35Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-883a50cf561d48859533856209eeeaf72023-11-22T00:29:40ZengMDPI AGAntibiotics2079-63822021-06-0110673110.3390/antibiotics10060731<i>Clostridioides difficile</i> Infection among Cirrhotic Patients with Variceal BleedingMirela Nicoleta Voicu0Florica Popescu1Dan Nicolae Florescu2Ion Rogoveanu3Adina Turcu-Stiolica4Dan Ionut Gheonea5Vlad Florin Iovanescu6Sevastita Iordache7Sergiu Marian Cazacu8Bogdan Silviu Ungureanu9Department of Pharmacology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Pharmacology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Gastroenterology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Gastroenterology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Pharmacoeconomics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Gastroenterology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Gastroenterology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Gastroenterology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Gastroenterology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Gastroenterology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania<i>Clostridioides difficile</i> infection (CDI) stands as the leading cause of nosocomial infection with high morbidity and mortality rates, causing a major burden on the healthcare system. Driven by antibiotics, it usually affects older patients with chronic disease or immunosuppressed or oncologic management. Variceal bleeding secondary to cirrhosis requires antibiotics to prevent bacterial translocation, and thus patients become susceptible to CDI. We aimed to investigate the risk factors for CDI in cirrhotic patients with variceal bleeding following ceftriaxone and the mortality risk in this patient’s population. We retrospectively screened 367 cirrhotic patients with variceal bleeding, from which 25 patients were confirmed with CDI, from 1 January 2017 to 31 December 2019. We found MELD to be the only multivariate predictor for mortality (odds ratio, OR = 1.281, 95% confidence interval, CI: 0.098–1.643, <i>p</i> = 0.042). A model of four predictors (age, days of admission, Charlson index, Child–Pugh score) was generated (area under the receiver operating characteristics curve, AUC = 0.840, 95% CI: 0.758–0.921, <i>p</i> < 0.0001) to assess the risk of CDI exposure. Determining the probability of getting CDI for cirrhotic patients with variceal bleeding could be a tool for doctors in taking decisions, which could be integrated in sustainable public health programs.https://www.mdpi.com/2079-6382/10/6/731<i>Clostridioides difficile</i>risk factorsCharlson comorbidity indexChild–Pugh score |
| spellingShingle | Mirela Nicoleta Voicu Florica Popescu Dan Nicolae Florescu Ion Rogoveanu Adina Turcu-Stiolica Dan Ionut Gheonea Vlad Florin Iovanescu Sevastita Iordache Sergiu Marian Cazacu Bogdan Silviu Ungureanu <i>Clostridioides difficile</i> Infection among Cirrhotic Patients with Variceal Bleeding Antibiotics <i>Clostridioides difficile</i> risk factors Charlson comorbidity index Child–Pugh score |
| title | <i>Clostridioides difficile</i> Infection among Cirrhotic Patients with Variceal Bleeding |
| title_full | <i>Clostridioides difficile</i> Infection among Cirrhotic Patients with Variceal Bleeding |
| title_fullStr | <i>Clostridioides difficile</i> Infection among Cirrhotic Patients with Variceal Bleeding |
| title_full_unstemmed | <i>Clostridioides difficile</i> Infection among Cirrhotic Patients with Variceal Bleeding |
| title_short | <i>Clostridioides difficile</i> Infection among Cirrhotic Patients with Variceal Bleeding |
| title_sort | i clostridioides difficile i infection among cirrhotic patients with variceal bleeding |
| topic | <i>Clostridioides difficile</i> risk factors Charlson comorbidity index Child–Pugh score |
| url | https://www.mdpi.com/2079-6382/10/6/731 |
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