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Metronidazole for Treatment of Clostridioides difficile Infections in Brazil: A Single-Center Experience and Risk Factors for Mortality

We describe the epidemiology of C. difficile infections (CDIs) focused on treatment and analyze the risk factors for mortality. This is a retrospective cohort study of CDI cases with a positive A/B toxin in the stool in 2017–2018. We analyzed the demographic data, comorbidities, previous use of anti...

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Autores principales: Alves, Joana Darc Freitas, Yamaguti, Augusto, de Mendonça, João Silva, de Melo Gamba, Cristiano, Fonseca, Cibele Lefreve, Paraskevopoulos, Daniela K. S., de Paula, Alexandre Inacio, Hosino, Nair, Costa, Silvia Figueiredo, Guimarães, Thaís
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9495058/
https://www.ncbi.nlm.nih.gov/pubmed/36139942
http://dx.doi.org/10.3390/antibiotics11091162
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author Alves, Joana Darc Freitas
Yamaguti, Augusto
de Mendonça, João Silva
de Melo Gamba, Cristiano
Fonseca, Cibele Lefreve
Paraskevopoulos, Daniela K. S.
de Paula, Alexandre Inacio
Hosino, Nair
Costa, Silvia Figueiredo
Guimarães, Thaís
author_facet Alves, Joana Darc Freitas
Yamaguti, Augusto
de Mendonça, João Silva
de Melo Gamba, Cristiano
Fonseca, Cibele Lefreve
Paraskevopoulos, Daniela K. S.
de Paula, Alexandre Inacio
Hosino, Nair
Costa, Silvia Figueiredo
Guimarães, Thaís
author_sort Alves, Joana Darc Freitas
collection PubMed
description We describe the epidemiology of C. difficile infections (CDIs) focused on treatment and analyze the risk factors for mortality. This is a retrospective cohort study of CDI cases with a positive A/B toxin in the stool in 2017–2018. We analyzed the demographic data, comorbidities, previous use of antimicrobials, severity, and treatment, and we performed multivariate analysis to predict the 30-days mortality. We analyzed 84 patients, 37 (44%) of which were male, where the mean age was 68.1 years and 83 (99%) had comorbidities. The percentage of positivity of the A/B toxin was 11.6%, and the overall incidence density was 1.78/10,000 patient days. Among the patients, 65.4% had previous use of antimicrobials, with third-generation cephalosporins being the class most prescribed, and 22.6% of cases were severe. Treatment was prescribed for 70 (83.3%) patients, and there was no statistically significant difference between the initial treatment with metronidazole and vancomycin even in severe cases. The 30-day mortality was 7/84 (8.3%), and the risk factors associated with mortality was a severity score ≥2 (OR: 6.0; CI: 1.15–31.1; p = 0.03). In this cohort of CDI-affected patients with comorbidities and cancer, metronidazole was shown to be a good option for treating CDIs, and the severity score was the only independent risk factor for death.
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spelling pubmed-94950582022-09-23 Metronidazole for Treatment of Clostridioides difficile Infections in Brazil: A Single-Center Experience and Risk Factors for Mortality Alves, Joana Darc Freitas Yamaguti, Augusto de Mendonça, João Silva de Melo Gamba, Cristiano Fonseca, Cibele Lefreve Paraskevopoulos, Daniela K. S. de Paula, Alexandre Inacio Hosino, Nair Costa, Silvia Figueiredo Guimarães, Thaís Antibiotics (Basel) Article We describe the epidemiology of C. difficile infections (CDIs) focused on treatment and analyze the risk factors for mortality. This is a retrospective cohort study of CDI cases with a positive A/B toxin in the stool in 2017–2018. We analyzed the demographic data, comorbidities, previous use of antimicrobials, severity, and treatment, and we performed multivariate analysis to predict the 30-days mortality. We analyzed 84 patients, 37 (44%) of which were male, where the mean age was 68.1 years and 83 (99%) had comorbidities. The percentage of positivity of the A/B toxin was 11.6%, and the overall incidence density was 1.78/10,000 patient days. Among the patients, 65.4% had previous use of antimicrobials, with third-generation cephalosporins being the class most prescribed, and 22.6% of cases were severe. Treatment was prescribed for 70 (83.3%) patients, and there was no statistically significant difference between the initial treatment with metronidazole and vancomycin even in severe cases. The 30-day mortality was 7/84 (8.3%), and the risk factors associated with mortality was a severity score ≥2 (OR: 6.0; CI: 1.15–31.1; p = 0.03). In this cohort of CDI-affected patients with comorbidities and cancer, metronidazole was shown to be a good option for treating CDIs, and the severity score was the only independent risk factor for death. MDPI 2022-08-28 /pmc/articles/PMC9495058/ /pubmed/36139942 http://dx.doi.org/10.3390/antibiotics11091162 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Alves, Joana Darc Freitas
Yamaguti, Augusto
de Mendonça, João Silva
de Melo Gamba, Cristiano
Fonseca, Cibele Lefreve
Paraskevopoulos, Daniela K. S.
de Paula, Alexandre Inacio
Hosino, Nair
Costa, Silvia Figueiredo
Guimarães, Thaís
Metronidazole for Treatment of Clostridioides difficile Infections in Brazil: A Single-Center Experience and Risk Factors for Mortality
title Metronidazole for Treatment of Clostridioides difficile Infections in Brazil: A Single-Center Experience and Risk Factors for Mortality
title_full Metronidazole for Treatment of Clostridioides difficile Infections in Brazil: A Single-Center Experience and Risk Factors for Mortality
title_fullStr Metronidazole for Treatment of Clostridioides difficile Infections in Brazil: A Single-Center Experience and Risk Factors for Mortality
title_full_unstemmed Metronidazole for Treatment of Clostridioides difficile Infections in Brazil: A Single-Center Experience and Risk Factors for Mortality
title_short Metronidazole for Treatment of Clostridioides difficile Infections in Brazil: A Single-Center Experience and Risk Factors for Mortality
title_sort metronidazole for treatment of clostridioides difficile infections in brazil: a single-center experience and risk factors for mortality
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9495058/
https://www.ncbi.nlm.nih.gov/pubmed/36139942
http://dx.doi.org/10.3390/antibiotics11091162
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