Healthcare associated Clostridioides difficile infection in adult surgical and medical patients hospitalized in tertiary hospital in Belgrade, Serbia: a seven years prospective cohort study

Figures & data

Table 1. Comparison of patients’ characteristics and factors related to healthcare in surgical and medical patients with HA CDI

	Surgical patients N = 268	Medical patients N = 285	Crude RR*	ULRA* P	MLRA* RR (95%CI)	MLRA p
Patients characteristic
Female sex, n (%)	123 (45.9)	128 (44.9)		0.883
Age, X ± SD	64.91 ± 14.86	68.59 ± 15.46		0.005
Age ≥ 65 years, n (%)	154 (57.5)	190 (66.7)	1.481	0.026	2.015 (1.347–3.014)	0.001
Diabetes mellitus, n (%)	37 (13.8)	51 (17.9)		0.231
Malignancy, n (%)	63 (23.5)	66 (23.2)		1.000
Previous infection, n (%)	97 (36.2)	128 (44.9)	1.437	0.037
Factors related to healthcare
Season of CDI infection Spring Summer Autumn Winter	78 (29.1) 59 (22.0) 65 (24.3) 66 (24.6)	95 (33.3) 66 (23.2) 56 (19.6) 68 (23.9)	0.524
Previous hospital admission	103 (38.4)	149 (52.3)	1.755	0.001
ICU*admission, n (%)	95 (35.4)	31 (10.9)	4.499	<0.001	4.730 (2.877–7.775)	<0.001
Length of stay in ICU, (days), X ± SD	7.16 ± 12.09	25.23 ± 33.97		<0.001
Nasogastric tube, n (%)	28 (10.4)	32 (11.2)		0.874
Mechanical ventilation, n (%)	39 (14.6)	44 (15.4)		0.863
Days of hospitalization prior CDI, X± SD	21.22 ± 18.68	17.79 ± 17.48		0.004
Proton-pump inhibitors, n (%)	51 (19.0)	111 (38.9)	2.714	<0.001	3.431 (2.188–5.379)	<0.001
H2 receptor antagonist, n (%)	109 (40.7)	111 (38.9)		0.744
Chemotherapy, n (%)	5 (1.9)	36 (12.6)	7.605	<0.001	4.708 (1.718–12.906)	0.003
Antibiotic exposure, n (%)	263 (98.1)	262 (91.9)	4.618	<0.001
Number of received antibiotics One Two Three Four	118 (44.9) 66 (25.1) 41 (15.6) 38 (14.4)	102 (38.9) 79 (30.2) 50 (19.1) 31 (11.8)		0.269
Days of usage an antibiotic (X± SD)	6.59 ± 4.79	8.63 ± 5.60		<0.001
Days of usage two antibiotics (X± SD)	7.50 ± 5.06	7.83 ± 5.46		0.519
Days of usage three antibiotics (X± SD)	7.62 ± 5.89	7.43 ± 4.23		0.656
Days of usage four antibiotics (X± SD)	8.45 ± 4.05	8.58 ± 4.79		0.995
Cephalosporins 1st gen, n (%)	24 (9.1)	17 (6.5)		0.335
Cephalosporins 2nd gen, n (%)	79 (30.0)	46 (17.6)	2.016	0.001	1.924 (1.177–3.145)	0.009
Cephalosporins 3rd gen, n (%)	170 (64.6)	139 (53.1)	1.618	0.007	2.173 (1.421–3.322)	<0.001
Cephalosporins 4th gen, n (%)	1 (0.4)	4 (1.5)		0.216
Aminoglycosides, n (%)	45 (17.1)	44 (16.8)		1.000
Fluoroquinolones, n (%)	26 (9.9)	75 (28.6)	3.656	<0.001	3.025 (1.751–5.226)	<0.001
Sulfonamides, n (%)	19 (7.2)	24 (9.2)		0.516
Carbapenems, n (%)	53 (20.2)	63 (24.0)		0.332
Macrolides, n (%)	5 (1.9)	14 (5.3)		0.060
Clindamycin, n (%)	7 (2.7)	2 (0.8)		0.176
Tigecyclin, n (%)	1 (0.4)	1 (0.4)		1.000
Fosfomycin, n (%)	0 (0)	2 (0.8)		0.249
Colistin, n (%)	4 (1.5)	2 (0.8)		0.686

*ICU, intensive care unit; *ULRA, univariable logistic regression analysis; *MLRA, multivariable logistic regression analysis; *RR, relative risk

Table 2. Outcomes in surgical and medical patients with Clostridioides difficile Infections (CDI)

	Surgical patients N = 268	Medical patients N = 285	p
Length of stay in hospital, (days), X ± SD	39.93 ± 30.64	36.49 ± 28.80	0.262
In hospital mortality, n (%)	53 (19.8)	80 (28.1)	0.029
30-day mortality, p < (%)	42 (15.7)	73 (25.6)	0.006
Recurrent CDI, p < (%)	22 (8.2)	17 (6.0)	0.388
Readmission to MMA*	14 (5.2)	13 (4.6)	0.718

*MMA, Military Medical Academy