ANTIMICROBIAL THERAPY AND CLOSTRIDIUM DIFFICILE INFECTION
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| Article Title: | ANTIMICROBIAL THERAPY AND CLOSTRIDIUM DIFFICILE INFECTION |
| Authors: | 1Olariu T, 1*Nicolescu A, 2Chiorean A, 3Dunca E, 4Negru D, 5Olariu I |
| Affiliation: | 1„Vasile Goldis” Western University of Arad, Department of Intensive Care, Arad, Romania 2„Iuliu Hatieganu” University of Medicine and Pharmacy, Department of Radiology and Medical Imaging, Cluj Napoca, Romania 3University of Petrosani, Faculty of Mining, Department of Management, Environmental Engineering, Geology, Petrosani, Romania 4County Emergency Hospital Clinic, Department of Laboratory, Arad, Romania 5„Vasile Goldis” Western University of Arad, Department of Dental Medicine, Arad, Romania |
| Abstract: | The study intends to evaluate antibiotic therapy in Clostridium difficile infection (CDI) in order to determine infection fatality risk rates depending on patient’s age and type of antibiotic therapy, assuming that those over 60 years old with broad spectrum cephalosporins and quinolones regimens are under aggravating risk factors. A number of 71 CDIs were analyzed of the 183 nosocomial infections registred in Arad Emergency Hospital taking into account patient age, previous admissions, contact with other ICD cases, prior antibiotic treatment and cases evolution. Gram positive bacteria have caused 52.5% of nosocomials, most of them assisted on surgical (17,7%), infectious diseases (15,6%,) and intensive care units ATI (12,5%). Most of them were enterocolitis (40,4%), urinary tract infections (21,8%) and nosocomial pneumoniae (16,1%). The CDI patients’average age was 67 years (extreme 20-88 years, Std.dev.14, 69). The gender ratio was F: M = 1.53, with fatal evolution for 12.7% of cases, the relative risk of death being 2.2791 for female patients. Broad-spectrum cephalosporins were given in 52.11% of cases and the relative risk for adverse outcome in patients over 60 years with ICD associated with third generation cephalosporins treatment was 17.6333 (P = 0.0430, 95% CI 1.0952 to 83.9138). CDI is the first cause of nosocomials in 2016 for Arad Emergency Hospital, being encouraged by broad-spectrum cephalosporins therapy in over 60 years old patients. |
| Keywords: | nosocomial, Clostridium difficile, cephalosporins |
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| *Correspondence: | • Olariu Teodora, MD, PhD, Full Professor „Vasile Goldis” Western University of Arad, Romania, Department of Intensive Care No.86 Liviu Rebreanu Street, 310045, Arad, Romania, Phone: +40-257-212204 • Nicolescu Amalia, MD, PhD, Teaching Assistant „Vasile Goldis” Western University of Arad, Romania, Department of Intensive Care No.86 Liviu Rebreanu Street, 310045, Arad, Romania, Phone: +40-257-212204 • Chiorean Angelica, MD, PhD, Lecturer „Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj Napoca, Romania”, Department of Radiology and Medical Imaging No. 1-3 Clinicilor Street, 3400, Cluj-Napoca, Romania, Phone: +40-64-120933 • Dunca Emilia, Eng, PhD, Associate Professor University of Petrosani, Faculty of Mining, Department of Management, Environmental Engineering, Geology No.20 University Street, 332006, Petroșani, Romania, Phone: + 40-54-549749 • Negru Dana, MD, PhD County Emergency Hospital Clinic, Arad, Department of Laboratory No. 2-4 Andreny Karoly Street, Arad, 310037, Romania, Phone: +40 – 357407200 • Olariu Iustin, MD, PhD „Vasile Goldis” Western University of Arad, Romania, Department of Dental Medicine No.86 Liviu Rebreanu Street, 310045, Arad, Romania, Phone: +40-257-21220 |
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