Reparto di Geriatria Lunardelli

Bologna, Italy

Reparto di Geriatria Lunardelli

Bologna, Italy
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Background. According to the World Health Organization, Clostridium difficile (CD) is the most frequent aetiological agent of bowel infections in the elderly, being responsible for the 15% of nosocomial diarrhea. Advanced age, long-term care, polypharmacotherapy (especially antibiotics and antiacids) are considered the main risk factors for developing infections. Methods. Retrospective case-control study based on the review of medical records of all patients admitted to three clinical units of "S. Orsola Malpighi" Hospital of Bologna (Acute Geriatric Unit, Extensive Rehabilitation Ward and Intensive Rehabilitation Ward). The aim was to determine the incidence of CD infections and their correlation with the presence of risk factors. Results. On 5869 patients analyzed, 487 had diarrhea. In 99 cases (20,3%) CD was detected as the aetiological pathogen. Patients with CD-associated diarrhea were significantly older than controls. About 60% of patients had used antibiotics within 60 days before the diagnosis, in particular beta-lactam, cephalosporins and quinolones. Proton pump inhibitors were used in 86% of CD-positive patients. Moreover, only 40% of CD infections was reported on DRG. Discussion. Our data are consistent with the literature, confirming that CD is the most frequent etiological agent of no socomial diarrhea. Its incidence is more frequent in long-term care patients and in the elderly. Our study reports a significantly higher incidence of CD-related diarrhea compared to Regional data, this discrepancy is probably due to underestimation of this syndrome in the hospital discharge records.

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