title: The epidemiological and clinical analysis of Clostridium difficile infections in patients hospitalized due to the infection at the Department of Infectious Diseases in Bytom.
abstract: Clostridium difficile infections are becoming a more serious problem as hospital-acquired infections and the consequence of common antibiotic therapy, also on an out-patient basis.
  
  
  OBJECTIVE
  The aim of the study was the epidemiological and clinical analysis of patients with Clostridium difficile-associated disease (CDAD) at the Clinical Department of Infectious Diseases and Hepatology, Bytom in 2014.
  
  
  METHODS
  A retrospective analysis of the medical documentation of patients with the diagnosis of CDAD was performed. The study group was comprised of 24 patients. The following factors were analysed: gender, age, recent hospitalization, use of proton-pump inhibitors, H2-receptor inhibitors, use of antibiotics, co-morbidities, and the clinical course with consideration given to additional laboratory tests (CRP, creatinine, WBC count).
  
  
  RESULTS
  All patients with diagnosed CDAD had been previously hospitalized and 75% of subjects were treated with antibiotics in the period preceding the onset of the disease. Recurrence of the disease was observed in 29% of cases, on average, 12.5 days after hospital discharge. In 16.7% of patients, CDAD resulted in death. Higher CRP concentrations on admission were observed in patients who died compared to the survivors (91.1 mg/l vs. 33.6 mg/l, p=0.015). Additionally, higher concentrations of CRP and leukocytosis were observed in patients with an unfavourable outcome of the disease. Respiratory insufficiency and hypotension were connected with a higher risk of death.
  
  
  CONCLUSIONS
  Hospitalization, antibiotic therapy, advanced age and co-morbidities may contribute to the occurrence of CDAD. In our study, initially high concentrations of CRP, respiratory insufficiency and hypotension were the predictive factors of a fatal outcome of the disease. The dynamics of changes in the leukocyte value and CRP concentration were of lesser importance.
authors.affiliation: Clinical Department of Infectious Diseases and Hepatology in Bytom, Medical University of Silesia, Katowice, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Stolarz
authors.affiliation: Clinical Department of Infectious Diseases and Hepatology in Bytom, Medical University of Silesia, Katowice, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Sobala-Szczygieł
authors.affiliation: Clinical Department of Infectious Diseases and Hepatology in Bytom, Medical University of Silesia, Katowice, Poland.
authors.forename: Damian
authors.initials: D
authors.lastname: Piotrowski
authors.affiliation: Clinical Department of Infectious Diseases and Hepatology in Bytom, Medical University of Silesia, Katowice, Poland.
authors.forename: Lucjan
authors.initials: L
authors.lastname: Kępa
authors.affiliation: Clinical Department of Infectious Diseases and Hepatology in Bytom, Medical University of Silesia, Katowice, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Oczko-Grzesik
authors.affiliation: Clinical Department of Infectious Diseases and Hepatology in Bytom, Medical University of Silesia, Katowice, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Boroń-Kaczmarska
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality*; D003428:Cross Infection / Q000453:epidemiology; D003967:Diarrhea / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality*; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D011044:Poland; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents