ArticleCritical care (London, England)2012
Outcome of ICU patients with Clostridium difficile infection.
Article in Critical care (London, England), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Global burden ofJournal of global health · 2019Pooled it
- Risk Factors and Outcomes of Clostridioides difficile Infection in Respiratory Intensive Care Unit Patients.The clinical respiratory journal · 2025Article
- Post-DischargeInternational journal of environmental research and public health · 2022Observational
- Clostridioides difficile infections in the intensive care unit: a monocentric cohort study.Infection · 2020Article
- Diarrhoea in critical care is rarely infective in origin, associated with increased length of stay and higher mortality.Journal of the Intensive Care Society · 2020Article
- Clostridioides difficile (formerly Clostridium difficile) infection in the critically ill: an expert statement.Intensive care medicine · 2020Review
- Initial therapy affects duration of diarrhoea in critically ill patients with Clostridioides difficile infection (CDI).Critical care (London, England) · 2019Article
- Rescue fecal microbiota transplantation for antibiotic-associated diarrhea in critically ill patients.Critical care (London, England) · 2019Article
- Article
- Risk prediction for 30-day mortality among patients withAntimicrobial resistance and infection control · 2019Article
- Nonsteroidal Anti-Inflammatory Drugs Impact on the Outcomes of Hospitalized Patients withClinical and experimental gastroenterology · 2019Article
- Sleeping with the enemy: Clostridium difficile infection in the intensive care unit.Critical care (London, England) · 2017Review
- Treatment intensity and outcome of nonagenarians selected for admission in ICUs: a multicenter study of the Outcomerea Research Group.Annals of intensive care · 2016Article
- Diarrhoea in the critically ill is common, associated with poor outcome, and rarely due to Clostridium difficile.Scientific reports · 2016Article
- Article
- Prevalence and Clinical Outcomes of Clostridium difficile Infection in the Intensive Care Unit: A Systematic Review and Meta-Analysis.Open forum infectious diseases · 2016Article
- Hospital acquired diarrhea in a burn center of Tehran.Iranian journal of microbiology · 2015Article
- Epidemiology and outcomes of community-acquired Clostridium difficile infections in Medicare beneficiaries.Journal of the American College of Surgeons · 2014Article
- Clostridium difficile colitis acquired in the intensive care unit: outcome and prognostic factors.Infection · 2014Article
- ICU-Onset Clostridium difficile infection in a university hospital in China: a prospective cohort study.PloS one · 2014Article
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12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAs data from Clostridium difficile infection (CDI) in intensive care unit (ICU) are still scarce, our objectives were to assess the morbidity and mortality of ICU-acquired CDI.
methodsWe compared patients with ICU-acquired CDI (watery or unformed stools occurring ≥ 72 hours after ICU admission with a stool sample positive for C. difficile toxin A or B) with two groups of controls hospitalized at the same time in the same unit. The first control group comprised patients with ICU-acquired diarrhea occurring ≥ 72 hours after ICU admission with a stool sample negative for C. difficile and for toxin A or B. The second group comprised patients without any diarrhea.
resultsAmong 5,260 patients, 512 patients developed one episode of diarrhea. Among them, 69 (13.5%) had a CDI; 10 (14.5%) of them were community-acquired, contrasting with 12 (17.4%) that were hospital-acquired and 47 (68%) that were ICU-acquired. A pseudomembranous colitis was associated in 24/47 (51%) ICU patients. The median delay between diagnosis and metronidazole administration was one day (25th Quartile; 75th Quartile (0; 2) days). The case-fatality rate for patients with ICU-acquired CDI was 10/47 (21.5%), as compared to 112/443 (25.3%) for patients with negative tests. Neither the crude mortality (cause specific hazard ratio; CSHR = 0.70, 95% confidence interval; CI 0.36 to 1.35, P = 0.3) nor the adjusted mortality to confounding variables (CSHR = 0.81, 95% CI 0.4 to 1.64, P = 0.6) were significantly different between CDI patients and diarrheic patients without CDI. Compared to the general ICU population, neither the crude mortality (SHR = 0.64, 95% CI 0.34 to 1.21, P = 0.17), nor the mortality adjusted to confounding variables (CSHR = 0.71, 95% confidence interval (CI) 0.38 to 1.35, P = 0.3), were significantly different between the two groups. The estimated increase in the duration of stay due to CDI was 8.0 days ± 9.3 days, (P = 0.4) in comparison to the diarrheic population, and 6.3 days ± 4.3 (P = 0.14) in comparison to the general ICU population.
conclusionsIf treated early, ICU-acquired CDI is not independently associated with an increased mortality and impacts marginally the ICU length of stay.
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