Clostridioides difficile infection in mechanically ventilated critically ill patients : A nested cohort study
Crown Copyright © 2023. Published by Elsevier Inc. All rights reserved..
INTRODUCTION: Clostridioides difficile infection (CDI) is a serious complication of critical illness. The objective of the study was to determine its incidence, prevalence, timing, severity, predictors, and outcomes.
METHODS: We performed a prospective nested cohort study of CDI within a randomized trial comparing Lactobacillus rhamnosus GG to placebo. We adjudicated cases of CDI using standardized definitions, assessed timing (pre-ICU, in ICU, post-ICU) and severity. We analyzed risk factors and outcomes.
RESULTS: Of 2650 patients, 86 were diagnosed with CDI during 90,833 hospital-days (0.95/1000 hospital-days); CDI prevalence was 3.2%. CDI incidence varied in timing; 0.3% patients had CDI pre-ICU, 2.2% in the ICU; an 0.8% developed CDI post-ICU. Relapse or recurrence of CDI was documented in 9.3% patients. Infections were mild/moderate in severity. Complications included septic shock (26.7%), organ failure (16.3%), and toxic megacolon requiring colectomy (1.2%). No risk factors for CDI were identified. CDI was not associated with hospital mortality. The duration of hospital stay was longer for those who had CDI compared those who did not, CONCLUSION: CDI was uncommon, severity was mild to moderate and not associated with mortality however CDI was associated with a longer hospital stay.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:75 |
|---|---|
| Enthalten in: |
Journal of critical care - 75(2023) vom: 20. Juni, Seite 154254 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Dionne, Joanna C [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Clostridioides difficile infection |
|---|
| Anmerkungen: |
Date Completed 24.04.2023 Date Revised 28.05.2023 published: Print-Electronic ClinicalTrials.gov: NCT02462590 Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.jcrc.2023.154254 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM351936203 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM351936203 | ||
| 003 | DE-627 | ||
| 005 | 20231226052602.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.jcrc.2023.154254 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1173.xml |
| 035 | |a (DE-627)NLM351936203 | ||
| 035 | |a (NLM)36682909 | ||
| 035 | |a (PII)S0883-9441(23)00003-5 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Dionne, Joanna C |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Clostridioides difficile infection in mechanically ventilated critically ill patients |b A nested cohort study |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 24.04.2023 | ||
| 500 | |a Date Revised 28.05.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT02462590 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Crown Copyright © 2023. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a INTRODUCTION: Clostridioides difficile infection (CDI) is a serious complication of critical illness. The objective of the study was to determine its incidence, prevalence, timing, severity, predictors, and outcomes | ||
| 520 | |a METHODS: We performed a prospective nested cohort study of CDI within a randomized trial comparing Lactobacillus rhamnosus GG to placebo. We adjudicated cases of CDI using standardized definitions, assessed timing (pre-ICU, in ICU, post-ICU) and severity. We analyzed risk factors and outcomes | ||
| 520 | |a RESULTS: Of 2650 patients, 86 were diagnosed with CDI during 90,833 hospital-days (0.95/1000 hospital-days); CDI prevalence was 3.2%. CDI incidence varied in timing; 0.3% patients had CDI pre-ICU, 2.2% in the ICU; an 0.8% developed CDI post-ICU. Relapse or recurrence of CDI was documented in 9.3% patients. Infections were mild/moderate in severity. Complications included septic shock (26.7%), organ failure (16.3%), and toxic megacolon requiring colectomy (1.2%). No risk factors for CDI were identified. CDI was not associated with hospital mortality. The duration of hospital stay was longer for those who had CDI compared those who did not, CONCLUSION: CDI was uncommon, severity was mild to moderate and not associated with mortality however CDI was associated with a longer hospital stay | ||
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Clostridioides difficile infection | |
| 650 | 4 | |a Critical illness | |
| 650 | 4 | |a Epidemiology | |
| 650 | 4 | |a Probiotics | |
| 700 | 1 | |a Johnstone, Jennie |e verfasserin |4 aut | |
| 700 | 1 | |a Heels-Ansdell, Diane |e verfasserin |4 aut | |
| 700 | 1 | |a Duan, Erick |e verfasserin |4 aut | |
| 700 | 1 | |a Lauzier, Francois |e verfasserin |4 aut | |
| 700 | 1 | |a Arabi, Yaseen M |e verfasserin |4 aut | |
| 700 | 1 | |a Adhikari, Neill K J |e verfasserin |4 aut | |
| 700 | 1 | |a Sligl, Wendy |e verfasserin |4 aut | |
| 700 | 1 | |a Dodek, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Rochwerg, Bram |e verfasserin |4 aut | |
| 700 | 1 | |a Marshall, John C |e verfasserin |4 aut | |
| 700 | 1 | |a Niven, Daniel J |e verfasserin |4 aut | |
| 700 | 1 | |a Williamson, David R |e verfasserin |4 aut | |
| 700 | 1 | |a Reynolds, Steven |e verfasserin |4 aut | |
| 700 | 1 | |a Zytaruk, Nicole |e verfasserin |4 aut | |
| 700 | 1 | |a Cook, Deborah |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of critical care |d 1987 |g 75(2023) vom: 20. Juni, Seite 154254 |w (DE-627)NLM074731068 |x 1557-8615 |7 nnns |
| 773 | 1 | 8 | |g volume:75 |g year:2023 |g day:20 |g month:06 |g pages:154254 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.jcrc.2023.154254 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 75 |j 2023 |b 20 |c 06 |h 154254 | ||