Clostridium Difficile Infection Due to Pneumonia Treatment: Mortality Risk Models.
One of the most common gastrointestinal infection after the antibiotic treatment of community or nosocomial pneumonia is caused by the anaerobic spore Clostridium difficile (C. difficile). The aim of this study was to retrospectively assess mortality due to C. difficile infection (CDI) in patients treated for pneumonia. We identified 94 cases of post-pneumonia CDI out of the 217 patients with CDI. The mortality issue was addressed by creating a mortality risk models using logistic regression and multivariate fractional polynomial analysis. The patients' demographics, clinical features, and laboratory results were taken into consideration. To estimate the influence of the preceding respiratory infection, a pneumonia severity scale was included in the analysis. The analysis showed two statistically significant and clinically relevant mortality models. The model with the highest prognostic strength entailed age, leukocyte count, serum creatinine and urea concentration, hematocrit, coexisting neoplasia or chronic obstructive pulmonary disease. In conclusion, we report on two prognostic models, based on clinically relevant factors, which can be of help in predicting mortality risk in C. difficile infection, secondary to the antibiotic treatment of pneumonia. These models could be useful in preventive tailoring of individual therapy.
Department of Family Medicine with Internal and Metabolic Diseases, Medical University of Warsaw, 19/25 Stępinska Street, 00-739, Warsaw, Poland.
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Chmielewska
Department of Family Medicine with Internal and Metabolic Diseases, Medical University of Warsaw, 19/25 Stępinska Street, 00-739, Warsaw, Poland. kzycinska@poczta.fm.
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Zycinska
Department of Family Medicine with Internal and Metabolic Diseases, Medical University of Warsaw, 19/25 Stępinska Street, 00-739, Warsaw, Poland.
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Lenartowicz
Department of Family Medicine with Internal and Metabolic Diseases, Medical University of Warsaw, 19/25 Stępinska Street, 00-739, Warsaw, Poland.
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Hadzik-Błaszczyk
Department of Family Medicine with Internal and Metabolic Diseases, Medical University of Warsaw, 19/25 Stępinska Street, 00-739, Warsaw, Poland.
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Cieplak
Department of Family Medicine with Internal and Metabolic Diseases, Medical University of Warsaw, 19/25 Stępinska Street, 00-739, Warsaw, Poland.
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Kur
Department of Family Medicine with Internal and Metabolic Diseases, Medical University of Warsaw, 19/25 Stępinska Street, 00-739, Warsaw, Poland.
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Wardyn
D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D016360:Clostridioides difficile / Q000302:isolation & purification*; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis / Q000382:microbiology* / Q000401:mortality*; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D011014:Pneumonia / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
D000900:Anti-Bacterial Agents
Clostridium difficile; Infection; Mortality risk; Pneumonia; Prognostic model