1. Epidemiology and outcome of Clostridium difficile infections in patients hospitalized in Internal Medicine: findings from the nationwide FADOI-PRACTICE study
- Author
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Cioni, Giorgio, Viale, Pierluigi, Frasson, Stefania, Cipollini, Francesco, Menichetti, Francesco, Petrosillo, Nicola, Brunati, Sergio, Spigaglia, Patrizia, Vismara, Chiara, Bielli, Alessandra, Barbanti, Fabrizio, Landini, Giancarlo, Panigada, Grazia, Gussoni, Gualberto, Bonizzoni, Erminio, Gesu, Giovanni Pietro, Costantino, A., Masciari, R., Amato, G., Fontanella, A., Gallucci, F., Improta, L., Poggiano, M. R., Rabitti, P., Uomo, G., Civardi, G., Confalonieri, M., Grandi, M., Sacchetti, C., Baldini, T., Cioni, G., Miglioli, S., Sarti, M., Landini, M. P., Panuccio, D., Romboli, E., Vocale, C., Berti, F., Bonito, L., Gozzo, M. L., Manfellotto, D., Natili, S., Patti, A., Piccolo, P., Pistella, E., Santini, C., Pastorelli, R., Pellegrinotti, M., Quaratino, C. P., Bona, R., Gnerre, P., Lillo, F., Parodi, L., Bovero, A., Santoriello, L., Agnelli, F., Colombo, F., Gesu, G., Lombardi, G., Lanzetti, V., Biagiotti, S., Clerici, P., Mazzone, A., Brusco, G., Magnani, L., Tirella, S., Terulla, C., Manso, E., Nitti, C., Salvi, A., Ciarambino, T., Pepe, C., Politi, C., Frediani, R., Moschella, A., Lodolo, L., Barasolo, G., Bertoncelli, M. C., Milano, F., Campanini, M., Molinari, G. L., Pittau, S., De Bernochi, A., Giusti, M., Montegrosso, G., Errico, M., Mastroianni, F., Tauro, L., Caddori, A., Prasciolu, C. G., Di Naso, C., Romano, M., D'Angelo, A., Genco, L., Mangano, G., Arena, F., Biagioni, C., Cimolato, B., Landini, G., Nozzoli, C., Poli, A., Rossolini, G., Burzigotti, F., Francioni, S., Lenti, S., Galanti, I. A., Belcari, C., Longo, B., Salamone, D., Chiti, I., Lencioni, P., Panigada, G., Teghini, L., Gambacorta, M., Perrotta, U., Battaglia, G., Pizzato, E., Vian, A., De Menis, E., Bordignon, G., Tramontin, P., Doroldi, C., Ravagnan, P., Sartore, P., Leoni, M., Pauletto, P., Rigoli, R., Callegari, C., Sacchetta, A., Vendrame, A., Cioni G, Viale P, Frasson S, Cipollini F, Menichetti F, Petrosillo N, Brunati S, Spigaglia P, Vismara C, Bielli A, Barbanti F, Landini G, Panigada G, Gussoni G, Bonizzoni E, and Gesu G P
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Diarrhea ,Male ,medicine.medical_specialty ,genetic structures ,medicine.drug_class ,Antibiotics ,Real-Time Polymerase Chain Reaction ,lcsh:Infectious and parasitic diseases ,Immunoenzyme Techniques ,03 medical and health sciences ,0302 clinical medicine ,Medical microbiology ,Clostridium difficile ,Incidence ,Internal Medicine ,Outcome ,Predictors ,Aged ,Aged, 80 and over ,Anti-Bacterial Agents ,Clostridium Infections ,Female ,Hospital Mortality ,Humans ,Italy ,Length of Stay ,Middle Aged ,Prospective Studies ,Infectious Diseases ,Internal medicine ,Epidemiology ,medicine ,80 and over ,lcsh:RC109-216 ,030212 general & internal medicine ,Prospective cohort study ,Clostridioides difficile ,business.industry ,Incidence (epidemiology) ,clostridium difficile ,incidence ,internal medicine ,outcome ,predictors ,aged ,aged, 80 and over ,anti-bacterial agents ,clostridioides difficile ,clostridium infections ,diarrhea ,female ,hospital mortality ,humans ,immunoenzyme techniques ,length of stay ,male ,middle aged ,prospective studies ,real-time polymerase chain reaction ,Tropical medicine ,clostridium difficile GDH EPIDEMIOLOGY ,030211 gastroenterology & hepatology ,medicine.symptom ,business ,Research Article - Abstract
Background Clostridium difficile (CD) is a leading cause of diarrhoea among hospitalized patients. The objective of this study was to evaluate the rate, the optimal diagnostic work-up, and outcome of CD infections (CDI) in Internal Medicine (IM) wards in Italy. Methods PRACTICE is an observational prospective study, involving 40 IM Units and evaluating all consecutive patients hospitalized during a 4-month period. CDI were defined in case of diarrhoea when both enzyme immunoassay for GDH, and test for A/B toxin were positive. Patients with CDI were followed-up for recurrences for 4 weeks after the end of therapy. Results Among the 10,780 patients observed, 103 (0.96 %) showed CDI, at admission or during hospitalization. A positive history for CD, antibiotics in the previous 4 weeks, recent hospitalization, female gender and age were significantly associated with CDI (multivariable analysis). In-hospital mortality was 16.5 % in CD group vs 6.7 % in No-CD group (p
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