title: [The disease caused by Clostridium difficile in geriatric patients].
abstract: BACKGROUND
  The disease caused by the bacterium Clostridium difficile/Clostridium difficile associated disease/diarrhoea (CDAD) is becoming a serious problem especially in geriatric patients, who are now relatively often treated by broad-spectrum antibiotics. The goal of our study was to evaluate the occurrence of the risk factors and to evaluate the complex of relations and coherence which lead to the CDAD disease in a selected group of seniors treated at our institution.
  
  
  METHODS
  The retrospective study evaluated a group of 67 patients with diagnosed CDAD, who were hospitalized at the clinic of internal medicine, geriatrics and practical medicine, Faculty of Medicine and Faculty Hospital in Brno from January 2007 till October 2010. In the study 46 women (68.7%) and 21 men (31.3%) were included of the average age 78.8 +/- 10.3 years (56 till 96 years). The decisive moment in the diagnosis of CDAD was the discovery of enterotoxines A and B in faeces of the patients.
  
  
  RESULTS
  The mean time of hospitalization of the patients suffering from CDAD was significantly higher (p = 0.01) in comparison with the control patients (24.63 +/- 16.34 vs. 11.5 +/- 10.7 days). Polymorbidity was also high in those patients. On average, each patient was ill with 11.3 diseases. The most frequent diseases were: high blood pressure (76.1% of the patients), ischemic heart disease 68.7% and the third most frequent diagnosis was the cerebrovascular disease 50.7%. We found that only 13 patients (19.4%) did not take the antibiotics at all, further 54 patients (80.6%) used one or more antibiotics. From the cohort of 67 patients 12 died (17.9%), the section was done in 7 patients, and colitis pseudomembranosa was proved in 3 of them. In 8 cases relapse of the colitis was proved.
  
  
  CONCLUSIONS
  The infection of the clostridium is a very serious disease which increases the morbidity and mortality in geriatric patients. Besides the demands on the diagnostics and therapy, it influences also the duration of the hospitalization.
authors.affiliation: Masarykova univerzita v Brne, Klinika interní, geriatrie a praktického lékarství LF a FN. bielakovak@seznam.cz
authors.forename: Katarína
authors.initials: K
authors.lastname: Bielaková
authors.forename: Pavel
authors.initials: P
authors.lastname: Weber
authors.forename: Hana
authors.initials: H
authors.lastname: Matejovská-Kubesová
authors.forename: Alena
authors.initials: A
authors.lastname: Sevcíková
authors.forename: Martin
authors.initials: M
authors.lastname: Vrba
authors.forename: Marie
authors.initials: M
authors.lastname: Kolárová
authors.forename: Petronela
authors.initials: P
authors.lastname: Ambrosová
authors.forename: Monika
authors.initials: M
authors.lastname: Korbelova-Nagyová
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000175:diagnosis* / Q000628:therapy; D003967:Diarrhea / Q000382:microbiology; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors