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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.
Afiliação
  • Alves JDF; Infectious Diseases Department, Hospital do Servidor Público Estadual de São Paulo, São Paulo 04029-000, Brazil.
  • Yamaguti A; Infectious Diseases Department, Hospital do Servidor Público Estadual de São Paulo, São Paulo 04029-000, Brazil.
  • de Mendonça JS; Infectious Diseases Department, Hospital do Servidor Público Estadual de São Paulo, São Paulo 04029-000, Brazil.
  • de Melo Gamba C; Infectious Diseases Department, Hospital do Servidor Público Estadual de São Paulo, São Paulo 04029-000, Brazil.
  • Fonseca CL; Infectious Diseases Department, Hospital do Servidor Público Estadual de São Paulo, São Paulo 04029-000, Brazil.
  • Paraskevopoulos DKS; Infectious Diseases Department, Hospital do Servidor Público Estadual de São Paulo, São Paulo 04029-000, Brazil.
  • de Paula AI; Microbiology Department, Hospital do Servidor Público Estadual de São Paulo, São Paulo 04029-000, Brazil.
  • Hosino N; Microbiology Department, Hospital do Servidor Público Estadual de São Paulo, São Paulo 04029-000, Brazil.
  • Costa SF; Infectious Diseases Department, Hospital das Clínicas, University of São Paulo, São Paulo 05508-220, Brazil.
  • Guimarães T; Infectious Diseases Department, Hospital do Servidor Público Estadual de São Paulo, São Paulo 04029-000, Brazil.
Antibiotics (Basel) ; 11(9)2022 Aug 28.
Article em En | MEDLINE | ID: mdl-36139942
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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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies País/Região como assunto: America do sul / Brasil Idioma: En Revista: Antibiotics (Basel) Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Brasil País de publicação: Suíça

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies País/Região como assunto: America do sul / Brasil Idioma: En Revista: Antibiotics (Basel) Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Brasil País de publicação: Suíça