PMID- 29967835
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220318
IS  - 2393-1809 (Print)
IS  - 2393-1817 (Electronic)
IS  - 2393-1817 (Linking)
VI  - 2
IP  - 1
DP  - 2016 Jan
TI  - Factors Favouring the Development of Clostridium Difficile Infection in 
      Critically Ill Patients.
PG  - 38-43
LID - 10.1515/jccm-2016-0006 [doi]
AB  - Clostridium difficile, an anaerobic, spore-forming, toxin-forming, gram-positive 
      bacillus present in the bacterial flora of the colon is the principal cause of 
      nosocomial diarrhoea in adults. AIM: Assessment of favouring factors of 
      Clostridium difficile infections as well as the interactions between them, in 
      critically ill hospitalized patients undergoing complex medical and surgical 
      treatments. MATERIAL AND METHODS: A retrospective case-control study involving 
      eighty patients admitted in the Intensive Care Unit (ICU) of the County Clinical 
      Emergency Hospital Tirgu-Mures was conducted between January and October 2014. 
      Patients aged eighteen years and over, who had undergone complex medical and 
      surgical treatment, were divided into two subgroups. Group 1 included patients 
      who developed diarrhoea but were not diagnosed as having a Clostridium difficile 
      infection (CDI). Group 2 included patients who developed diarrhoea due to CDI as 
      indicated by a positive culture and the expression of exotoxin. The assessed 
      parameters were age, length of stay (LOS), antibiotic spectrum, association with 
      proton pump inhibitors (PPI) or H2-receptor antagonists, immunological status, 
      the presence or lack of gastrointestinal tract surgery. RESULTS: The mean age was 
      64.6 years with an average LOS of 10 days. Fifty-six percent of patients came to 
      the ICU from internal medicine wards and forty-three percent from surgical wards. 
      20.5% of them were immunosuppressed. Co-association of ceftriaxone and 
      pantoprazole significantly increased the risk of CDI compared to 
      co-administration of any other antibiotic or pantoprazole (p=0.01). The odds 
      ratio for Pantoprazole together with any antibiotic versus antibiotic therapy 
      alone was significantly higher (p=0.018) with a sevenfold increase in the risk of 
      positive exotoxin increase. CONCLUSIONS: Antibiotic use is associated with "no 
      risk to develop CDI" in the first five days of administration. PPIs associated 
      therapy increased the risk of CDI in first seventy-two hours regardless of the 
      antibiotic type, and contributes to an active expression of CD exotoxin.
FAU - Grigorescu, Bianca-Liana
AU  - Grigorescu BL
AD  - University of Medicine and Pharmacy of Tirgu Mures, 38 Gheorghe Marinescu street, 
      Tirgu Mures, 540139, Romania.
FAU - Fodor, Raluca Stefania
AU  - Fodor RS
AD  - University of Medicine and Pharmacy of Tirgu Mures, 38 Gheorghe Marinescu street, 
      Tirgu Mures, 540139, Romania.
FAU - Cioc, Adrian Dan
AU  - Cioc AD
AD  - County Clinical Emergency Hospital Tirgu Mures, Romania, 50 Gheorghe Marinescu 
      street, Tirgu Mures, 540139, Romania.
FAU - Veres, Mihaly
AU  - Veres M
AD  - County Clinical Emergency Hospital Tirgu Mures, Romania, 50 Gheorghe Marinescu 
      street, Tirgu Mures, 540139, Romania.
FAU - Orlandea, Monica
AU  - Orlandea M
AD  - County Clinical Emergency Hospital Tirgu Mures, Romania, 50 Gheorghe Marinescu 
      street, Tirgu Mures, 540139, Romania.
FAU - Lazescu, Bogdan
AU  - Lazescu B
AD  - County Clinical Emergency Hospital Tirgu Mures, Romania, 50 Gheorghe Marinescu 
      street, Tirgu Mures, 540139, Romania.
FAU - Almasy, Emoke
AU  - Almasy E
AD  - County Clinical Emergency Hospital Tirgu Mures, Romania, 50 Gheorghe Marinescu 
      street, Tirgu Mures, 540139, Romania.
LA  - eng
PT  - Journal Article
DEP - 20160209
PL  - Poland
TA  - J Crit Care Med (Targu Mures)
JT  - Journal of critical care medicine (Universitatea de Medicina si Farmacie din 
      Targu-Mures)
JID - 101706934
PMC - PMC5939141
OTO - NOTNLM
OT  - Clostridium difficile
OT  - Pantoprazole
OT  - antibiotic therapy
OT  - nosocomial infection
EDAT- 2016/02/09 00:00
MHDA- 2016/02/09 00:01
PMCR- 2016/02/09
CRDT- 2018/07/04 06:00
PHST- 2015/06/23 00:00 [received]
PHST- 2015/10/22 00:00 [accepted]
PHST- 2018/07/04 06:00 [entrez]
PHST- 2016/02/09 00:00 [pubmed]
PHST- 2016/02/09 00:01 [medline]
PHST- 2016/02/09 00:00 [pmc-release]
AID - jccm-2016-0006 [pii]
AID - 10.1515/jccm-2016-0006 [doi]
PST - epublish
SO  - J Crit Care Med (Targu Mures). 2016 Feb 9;2(1):38-43. doi: 
      10.1515/jccm-2016-0006. eCollection 2016 Jan.