Outcomes of Clostridioides difficile infection in adult cancer and non-cancer patients hospitalised in a tertiary hospital: a prospective cohort study
Само за регистроване кориснике
2022
Аутори
Milenković, BojanaŠuljagić, Vesna
Perić, Aneta
Dragojević-Simić, Viktorija
Tarabar, Olivera
Milanović, Milomir
Putić, Vesna
Tomić, Diana
Miljković, Branislava
Vezmar-Kovačević, Sandra
Чланак у часопису (Објављена верзија)
Метаподаци
Приказ свих података о документуАпстракт
Background Clostridioides difficile infection (CDI) is one of the most common healthcare-associated (HA) infections. Cancer patients, particularly haemato-oncological patients, have an increased risk for CDI due to more risk factors compared with non-cancer patients. The aim of this study was to investigate differences in outcomes associated with HA CDI in patients with solid and haematological malignancies compared with patients with no underlying malignant disease in a tertiary healthcare centre in Serbia.
Methods A prospective cohort study was conducted including adult patients diagnosed with an initial episode of HA CDI. Their demographic and clinical characteristics associated with risk factors for CDI were documented. Outcomes such as all-cause 30-day mortality, cure of infection, diarrhoea relaps and recurrence of disease were followed. Patients were assigned to cancer and non-cancer groups. Within the cancer group, patients were divided into the solid tumour subgroup and hae...matological malignancy subgroup.
Results During a 7-year period, HA CDI was observed in 28 (5.1%) patients with haematological malignancy, 101 (18.3%) patients with solid tumours and 424 (76.7%) non-cancer patients. Older age (OR 1.04, 95% CI 1.02 to 1.07, p<0.001), admission to the intensive care unit (ICU) (OR 2.61, 95% CI 1.37 to 4.95, p=0.003), mechanical ventilation (OR 5.19, 95% CI 2.78 to 9.71, p<0.001) and use of antibiotics prior to CDI (OR 1.04, 95% CI 1.02 to 1.06, p=0.02) were associated with increased mortality. Compared with patients with solid tumours, patients with haematological malignancy were younger (65 vs 57 years, p=0.015), did not require ICU admission (25.0% vs 0%) or mechanical ventilation (8.9% vs 0%) and were treated longer with antibiotics prior to CDI (14 vs 24 days, p=0.002).
Conclusions Patients with haematological malignancy were exposed to different risk factors for CDI associated with mortality compared with patients with solid tumours and non-cancer patients. Older age, ICU stay and mechanical ventilation, but not presence or type of cancer, predicted the all-cause 30-day mortality.
Кључне речи:
drug-related side effects and adverse reactions / microbiology / clinical medicine / controlled clinical trial / education department / hospital / gastrointestinal neoplasms / head and neck neoplasms / hematology / kidney neoplasms / leukemia / multiple myeloma / transplantation / urologic neoplasmsИзвор:
European Journal of Hospital Pharmacy, 2022, 29, e1, e15-e22Издавач:
- British Medical Journal
Финансирање / пројекти:
- Ministry of Defence of the Republic of Serbia (Grant number: MF VMA 05/20-22)
DOI: 10.1136/ejhpharm-2020-002574
ISSN: 2047-9956
PubMed: 33579720
WoS: 000728294300001
Scopus: 2-s2.0-85135222845
Институција/група
PharmacyTY - JOUR AU - Milenković, Bojana AU - Šuljagić, Vesna AU - Perić, Aneta AU - Dragojević-Simić, Viktorija AU - Tarabar, Olivera AU - Milanović, Milomir AU - Putić, Vesna AU - Tomić, Diana AU - Miljković, Branislava AU - Vezmar-Kovačević, Sandra PY - 2022 UR - https://farfar.pharmacy.bg.ac.rs/handle/123456789/4829 AB - Background Clostridioides difficile infection (CDI) is one of the most common healthcare-associated (HA) infections. Cancer patients, particularly haemato-oncological patients, have an increased risk for CDI due to more risk factors compared with non-cancer patients. The aim of this study was to investigate differences in outcomes associated with HA CDI in patients with solid and haematological malignancies compared with patients with no underlying malignant disease in a tertiary healthcare centre in Serbia. Methods A prospective cohort study was conducted including adult patients diagnosed with an initial episode of HA CDI. Their demographic and clinical characteristics associated with risk factors for CDI were documented. Outcomes such as all-cause 30-day mortality, cure of infection, diarrhoea relaps and recurrence of disease were followed. Patients were assigned to cancer and non-cancer groups. Within the cancer group, patients were divided into the solid tumour subgroup and haematological malignancy subgroup. Results During a 7-year period, HA CDI was observed in 28 (5.1%) patients with haematological malignancy, 101 (18.3%) patients with solid tumours and 424 (76.7%) non-cancer patients. Older age (OR 1.04, 95% CI 1.02 to 1.07, p<0.001), admission to the intensive care unit (ICU) (OR 2.61, 95% CI 1.37 to 4.95, p=0.003), mechanical ventilation (OR 5.19, 95% CI 2.78 to 9.71, p<0.001) and use of antibiotics prior to CDI (OR 1.04, 95% CI 1.02 to 1.06, p=0.02) were associated with increased mortality. Compared with patients with solid tumours, patients with haematological malignancy were younger (65 vs 57 years, p=0.015), did not require ICU admission (25.0% vs 0%) or mechanical ventilation (8.9% vs 0%) and were treated longer with antibiotics prior to CDI (14 vs 24 days, p=0.002). Conclusions Patients with haematological malignancy were exposed to different risk factors for CDI associated with mortality compared with patients with solid tumours and non-cancer patients. Older age, ICU stay and mechanical ventilation, but not presence or type of cancer, predicted the all-cause 30-day mortality. PB - British Medical Journal T2 - European Journal of Hospital Pharmacy T1 - Outcomes of Clostridioides difficile infection in adult cancer and non-cancer patients hospitalised in a tertiary hospital: a prospective cohort study VL - 29 IS - e1 SP - e15 EP - e22 DO - 10.1136/ejhpharm-2020-002574 ER -
@article{ author = "Milenković, Bojana and Šuljagić, Vesna and Perić, Aneta and Dragojević-Simić, Viktorija and Tarabar, Olivera and Milanović, Milomir and Putić, Vesna and Tomić, Diana and Miljković, Branislava and Vezmar-Kovačević, Sandra", year = "2022", abstract = "Background Clostridioides difficile infection (CDI) is one of the most common healthcare-associated (HA) infections. Cancer patients, particularly haemato-oncological patients, have an increased risk for CDI due to more risk factors compared with non-cancer patients. The aim of this study was to investigate differences in outcomes associated with HA CDI in patients with solid and haematological malignancies compared with patients with no underlying malignant disease in a tertiary healthcare centre in Serbia. Methods A prospective cohort study was conducted including adult patients diagnosed with an initial episode of HA CDI. Their demographic and clinical characteristics associated with risk factors for CDI were documented. Outcomes such as all-cause 30-day mortality, cure of infection, diarrhoea relaps and recurrence of disease were followed. Patients were assigned to cancer and non-cancer groups. Within the cancer group, patients were divided into the solid tumour subgroup and haematological malignancy subgroup. Results During a 7-year period, HA CDI was observed in 28 (5.1%) patients with haematological malignancy, 101 (18.3%) patients with solid tumours and 424 (76.7%) non-cancer patients. Older age (OR 1.04, 95% CI 1.02 to 1.07, p<0.001), admission to the intensive care unit (ICU) (OR 2.61, 95% CI 1.37 to 4.95, p=0.003), mechanical ventilation (OR 5.19, 95% CI 2.78 to 9.71, p<0.001) and use of antibiotics prior to CDI (OR 1.04, 95% CI 1.02 to 1.06, p=0.02) were associated with increased mortality. Compared with patients with solid tumours, patients with haematological malignancy were younger (65 vs 57 years, p=0.015), did not require ICU admission (25.0% vs 0%) or mechanical ventilation (8.9% vs 0%) and were treated longer with antibiotics prior to CDI (14 vs 24 days, p=0.002). Conclusions Patients with haematological malignancy were exposed to different risk factors for CDI associated with mortality compared with patients with solid tumours and non-cancer patients. Older age, ICU stay and mechanical ventilation, but not presence or type of cancer, predicted the all-cause 30-day mortality.", publisher = "British Medical Journal", journal = "European Journal of Hospital Pharmacy", title = "Outcomes of Clostridioides difficile infection in adult cancer and non-cancer patients hospitalised in a tertiary hospital: a prospective cohort study", volume = "29", number = "e1", pages = "e15-e22", doi = "10.1136/ejhpharm-2020-002574" }
Milenković, B., Šuljagić, V., Perić, A., Dragojević-Simić, V., Tarabar, O., Milanović, M., Putić, V., Tomić, D., Miljković, B.,& Vezmar-Kovačević, S.. (2022). Outcomes of Clostridioides difficile infection in adult cancer and non-cancer patients hospitalised in a tertiary hospital: a prospective cohort study. in European Journal of Hospital Pharmacy British Medical Journal., 29(e1), e15-e22. https://doi.org/10.1136/ejhpharm-2020-002574
Milenković B, Šuljagić V, Perić A, Dragojević-Simić V, Tarabar O, Milanović M, Putić V, Tomić D, Miljković B, Vezmar-Kovačević S. Outcomes of Clostridioides difficile infection in adult cancer and non-cancer patients hospitalised in a tertiary hospital: a prospective cohort study. in European Journal of Hospital Pharmacy. 2022;29(e1):e15-e22. doi:10.1136/ejhpharm-2020-002574 .
Milenković, Bojana, Šuljagić, Vesna, Perić, Aneta, Dragojević-Simić, Viktorija, Tarabar, Olivera, Milanović, Milomir, Putić, Vesna, Tomić, Diana, Miljković, Branislava, Vezmar-Kovačević, Sandra, "Outcomes of Clostridioides difficile infection in adult cancer and non-cancer patients hospitalised in a tertiary hospital: a prospective cohort study" in European Journal of Hospital Pharmacy, 29, no. e1 (2022):e15-e22, https://doi.org/10.1136/ejhpharm-2020-002574 . .